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

Abstract

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.

Combination of Sac packing and liquid embolization using Double Microcatheter Technique for Renal Artery Aneurysm: A Case Report

“…DSA, especially 3D-DSA, can provide more anatomical information for further evaluation during endovascular treatment [6]. In our center, 3D-DSA is often used as the auxiliary diagnostic tool [7].…”

Arteriovenous Fistula: The Case of a Rare Complication after Minimal Percutaneous Nephrostomy and Brief Review

“…The complications of this method are those associated with any minimally invasive surgical procedure: vascular injury, damage to nearby organs, and infection [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. The Society of Cardiovascular and Interventional Radiology and the American College of Radiology have shown that percutaneous nephrostomy is associated with less than 4% major bleeding or septic shock [ 17 ].…”

“…Vascular injury can occur both at the time of puncture and minimal tract dilation by intercepting the vessels and during catheter movement. Symptomatology is abrupt, caused by hyperdistension of the pyelocaliceal system through clot accumulation causing colicky pain and hemorrhage that may be intrarenal or extrarenal and requires, for diagnostic certainty, either evidence of vascular lesion (aneurysm or arteriovenous fistula) by Doppler ultrasonography or fluoroscopic exploration (arteriography) [ 1 , 9 , 10 , 15 , 18 , 19 ].…”