Iatrogenic renovascular injuries treated by transarterial embolization

P. Song, M.-Q. Wang, F.-Y. Liu, F. Duan, Y. Wang

Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China. wangmq@vip.sina.com

 

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• Neurology

BACKGROUND: Renal vascular injury may be secondary to blunt or penetrating trauma, iatrogenic injuries or spontaneously with or without underlying pathology. The study aims to evaluate the effectiveness and safety of transarterial embolization (TAE) for the treatment of iatrogenic renovascular injuries (IRVIs).

PATIENTS AND METHODS: Thirty-six patients (27 males, 9 females, aged 14-79 years) with IRVIs were treated with TAE. Preprocedure computed tomography (CT) and/or ultrasound (US) and/or digital subtraction angiography (DSA) confirmed the presence of IRVIs in all 36 patients. The embolic materials include metallic coils, polyvinyl alcohol particles (PVA), gelfoam and n-butyl cyanoacrylate (NBCA) iodized oil mixture were used. The results of the embolization procedure were recorded. Patients were followed up, and complications of the procedure were noted.

RESULTS: A total of 40 embolization procedures were performed in 36 patients, and technical success was achieved in all procedures. Medical successes were achieved in 32 (89%) patients. Postembolization syndrome (back pain and fever) were detected in 12 patients (22%). Perirenal abscess was seen in one patient (3%). Puncture-site bleeding, nontarget embolization, decrease in renal function, and arterial hypertension were not detected in any of the patients.

CONCLUSIONS: TAE is an effective, minimally invasive treatment method for IRVIs. Therefore, TAE should be the first preferred treatment modality.

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