Safety and Efficacy of Transarterial Nephrectomy as an Alternative to Surgical Nephrectomy.
10.3348/kjr.2014.15.4.472
- Author:
Jooae CHOE
1
;
Ji Hoon SHIN
;
Hyun Ki YOON
;
Gi Young KO
;
Dong Il GWON
;
Heung Kyu KO
;
Jin Hyoung KIM
;
Kyu Bo SUNG
Author Information
1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. jhshin@amc.seoul.kr
- Publication Type:Original Article ; Evaluation Studies
- Keywords:
Kidney;
Embolization;
Nephrectomy
- MeSH:
Adult;
Aged;
Angiomyolipoma/therapy;
Arteriovenous Malformations/therapy;
Child;
Embolization, Therapeutic/adverse effects/*methods;
Female;
Graft Rejection/therapy;
Hematuria/etiology;
Humans;
Infarction/etiology;
Kidney/blood supply;
Kidney Diseases/surgery/*therapy;
Kidney Failure, Chronic/therapy;
Kidney Neoplasms/therapy;
Male;
Middle Aged;
Nephrectomy/adverse effects/*methods;
*Renal Artery/abnormalities;
Retrospective Studies;
Young Adult
- From:Korean Journal of Radiology
2014;15(4):472-480
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the safety and efficacy of transarterial nephrectomy, i.e., complete renal artery embolization, as an alternative to surgical nephrectomy. MATERIALS AND METHODS: This retrospective study included 11 patients who underwent transarterial nephrectomy due to a high risk of surgical nephrectomy or their refusal to undergo surgery during the period from April 2002 to February 2013. Medical records and radiographic images were reviewed retrospectively to collect information regarding underlying etiologies, clinical presentations and embolization outcomes. RESULTS: The underlying etiologies for transarterial nephrectomy included recurrent hematuria (chronic transplant rejection [n = 3], arteriovenous malformation or fistula [n = 3], angiomyolipoma [n = 1], or end-stage renal disease [n = 1]), inoperable renal or ureteral injury (n = 2), and ectopic kidney with urinary incontinence (n = 1). The technical success rate was 100%, while clinical success was achieved in eight patients (72.7%). Subsequent surgical nephrectomy was required for three patients due to an incomplete nephrectomy effect (n = 2) or necrotic pyelonephritis (n = 1). Procedure-related complications were post-infarction syndrome in one patient and necrotic pyelonephritis in another patient. Of four patients with follow-up CT, four showed renal atrophy and two showed partial renal enhancement. No patient developed a procedure-related hypertension. CONCLUSION: Transarterial nephrectomy may be a safe and effective alternative to surgical nephrectomy in patients with high operative risks.
