Endovascular management of arterial injuries after blunt or iatrogenic renal trauma

Loffroy, Romaric; Chevallier, Olivier; Gehin, Sophie; Midulla, Marco; Berthod, Pierre-Emmanuel; Galland, Christophe; Briche, Pascale; Duperron, C.; Majbri, Nabil; Mousson, Christiane; Falvo, Nicolas

doi:10.21037/qims.2017.08.04

Cited by 31 publications

(29 citation statements)

References 27 publications

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“…In recent years, even grade V renal traumas, historically treated with an open approach, are shifting towards a minimally invasive management. Several clinical criteria have been proposed to evaluate the opportunity to use renal embolization to deal with such high-grade injuries, as AAST grade, mechanism of injury, patient clinical stability and concomitant other organs injuries [ 37 ]. Surgery should be reserved in case of incontrollable hemorrhage, renal pedicle avulsion, and expanding uncontained hematoma of retroperitoneum.…”

Section: Kidneymentioning

confidence: 99%

Endovascular Interventional Radiology of the Urogenital Tract

Mucelli

Marrocchio

et al. 2021

Medicina

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Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.

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Section: Kidneymentioning

confidence: 99%

Endovascular Interventional Radiology of the Urogenital Tract

Mucelli

Marrocchio

et al. 2021

Medicina

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“…bleeders) may prove life saving [8]. The other indications for surgical interventions may include extensive renal injuries, expanding hematoma and extensive splenic injuries [9].…”

Section: International Journal Of Medical and Biomedical Studies (Ijmbs)mentioning

confidence: 99%

Blunt Abdominal Trauma With Haemoperitoneum Treated by Exploratory Laparotomy Versus Only Abdominal Drainage: A Prospective and Comparative Study.

Panchal

Dekhaiya

Tailor

2020

IJMBS

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In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients. Keywords: Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.

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“…Temporary clipping of the nephrostomy tube, application of hemostatic drugs, and blood transfusion are necessary conservative treatment measures [ 4 ]. It is recommended that angiography and embolization be performed by conservative treatment as early as possible in patients with severe hemorrhage [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Value of Angioembolization in the Treatment of Iatrogenic Renal Vascular Injury Assisted by 3-Dimensional Digital Subtraction Angiography

Liao

Fan

et al. 2020

Med Sci Monit

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Background This study was conducted to investigate the reliability and efficacy of polyvinyl alcohol combined with coils in the embolization of iatrogenic renal vascular injury with the assistance of 3-dimensional digital subtraction angiography (3D-DSA). Material/Methods Twenty-six patients with minimally invasive renal bleeding who underwent transarterial embolization from January 2012 to January 2019 in our hospital were included in the study. We obtained demographic data from these patients, as well as information on clinical presentation, renal procedures used for treatment, and perioperative details. The changes in renal function tests, serum hemoglobin, serum hematocrit, and technetium Tc 99m dimercaptosuccinic acid (99mTc-DMSA) levels pre- and postembolization were compared. In addition, the embolic area and the technical and clinical success rates were analyzed. Finally, an angiographic manifestation of the renal artery, 3D-DSA, and the effect of embolization were analyzed retrospectively. Results All patients achieved technical and clinical success after embolization (100%, 26/26). There were no significant differences between pre- and postoperative estimated glomerular filtration rate, serum parameters, and 99mTc-DMSA. The embolic area was 12%±10%. Patients did not exhibit severe complications during the follow-up period. Conclusions Proximal embolization technique assisted by 3D-DSA for renal iatrogenic hemorrhage and vascular lesions is both safe and efficacious, offering high rates for both clinical and technical success. It maximizes the protection of the kidney and reduces the rate of renal resection.

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Endovascular management of arterial injuries after blunt or iatrogenic renal trauma

Cited by 31 publications

References 27 publications

Endovascular Interventional Radiology of the Urogenital Tract

Endovascular Interventional Radiology of the Urogenital Tract

Blunt Abdominal Trauma With Haemoperitoneum Treated by Exploratory Laparotomy Versus Only Abdominal Drainage: A Prospective and Comparative Study.

Value of Angioembolization in the Treatment of Iatrogenic Renal Vascular Injury Assisted by 3-Dimensional Digital Subtraction Angiography

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