Perkutane Totalembolisation der Niere - eine Übersicht

Abstract

The percutaneous transarterial total embolization of the kidney is a minimal invasive therapeutic procedure for radiological nephrectomy. The reported indications, technique, results and complications of percutaneous transarterial total renal embolization are reviewed. Aside from transient symptoms as part of the postembolization syndrome with a stated incidence of 47 % to 100 % of embolizations, other complications are relatively rare and occur in the range of 0 % to 20 % with a mortality of up to 3.3 %. Technical success is high and not related to the diagnosis. However, clinical success depends on the underlying disease. Embolization of non-resectable renal tumors may improve the survival rate.

Radiologically Guided Renal Artery Embolization with an Amplatzer Vascular Plug as a Rescue Therapy for Refractory Nephrotic Syndrome in AL-Amyloidosis

“…To occlude the main renal artery directly, balloons, metal coils, and self-expanding wire meshes are used. The most common side effect of the procedure is postembolization syndrome with a reported frequency of 47-100% [6]. In the literature, the syndrome is characterized by fever, bilateral flank pain, leukocytosis, elevated blood sedimentation rate, rising levels of C-reactive protein, and lactate dehydrogenase.…”

“…With embolization on the capillary level, anuria normally develops. Accidental embolization of the infrarenal vascular bed has been reported to occur in around ten percent of patients [6], especially when small embolization particles or fluids are used. This can be prevented by transient proximal occlusion of the main renal artery with a balloon prior to injection of the embolization material.…”

“…For renal artery embolization, various materials are used with different success- and complication rates [4, 5]. A common side effect is postembolization syndrome with a reported frequency of 47-100% [6]. It is characterized by fever, flank pain, leukocytosis, and an elevated lactate dehydrogenase in the first few hours up to a few days after the embolization procedure.…”