Transcatheter Embolization in a Haemophiliac with Post-Traumatic Renal Haemorrhage

Abstract

Percutaneous transcatheter arterial embolization was performed in a case of severe haemophilia A to control haemorrhage secondary to renal trauma. The treatment proved to be life-saving. Eighteen months follow-up revealed no evidence of hypertension, renal failure or infection.

Long-Term Follow-Up of Renal Function and Blood Pressure After Selective Renal Arterial Embolization

“…Previous case reports or case series of patients who underwent renal artery embolization procedures reported that new-onset hypertension may occur, while renal function was neither well documented nor systematically followed. [8][9][10][11][12][13][14][15][16][17][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] The best available evidence for blood pressure and renal function outcomes data in patients who had therapeutic renal artery embolization prior to this study comes from a retrospective study by Jacobson et al, 9 which included 36 patients who had a total of 44 procedures. In that study, 14 of 36 patients (39%) had total or partial nephrectomies; renal artery embolization was a secondary therapeutic procedure, which was used to treat surgical complications, such as postnephrectomy bleeding.…”

“…[6][7][8][9] Several agents have been used to induce thrombosis of the target vessel(s), including metal coils, synthetic particulate materials, ethanol, foam sclerosing agents, acrylic glue, iodized oils, and autologous thrombi. [8][9][10][11][12][13][14][15][16] The long-term effects of renal embolization on hypertension and renal function are not well studied. The safety data are limited to case reports and small uncontrolled case series, some providing evidence that both severe hypertension 4,17 and worsening of renal function may occur.…”

Life-Threatening Post-Nephrolithotomy Hemorrhage Resulting in Cessation of Kidney Function, Treated by Transcatheter Arterial Embolization with Subsequent Restoration of Excretory Function

“…However, when almost the whole of the intrarenal arterial bed is embolized, even with resorbable materials like blood clots and Gelfoam, it can result in permanent cessation of renal function (5). In our case selective embolization controlled the acute renal bleeding and resulted in restoration of satisfactory function of the kidney.…”

“…Gelfoam is an effective embolizing material, even in cases with severe disturbances of blood coagulation, e.g. hemophilia (5). Also Gelfoam particles because of their resorption will allow partial or complete recanalization of the embolized vessel between 21 and 35 days after the procedure (14).…”