1.Emergency interventional embolization for the treatment of renal arterial hemorrhage
Jing YANG ; Bin BAI ; Wei XU ; Haili CAO ; Kaibing WAGN ; Zhongxing SHI ; Shuqiang JIN
Journal of Practical Radiology 2016;32(7):1102-1105,1108
Objective To evaluate the different arteriographic manifestations of acute renal arterial hemorrhage,and the treatment effects of emergency interventional embolization.Methods 87 patients with renal arterial hemorrhage who were failed to conservative treatment underwent the renal arteriography to confirm the position and degree of lesion.According to the arteriographic manifesta-tions,appropriate embolic agents such as spring coil,acrylic acid microspheres and the like were used to embolize the targeted vessel. The arteriographic manifestations and embolization efficacy were retrospectively analyzed.Results Contrast medium leakage was showed by renal angiography in 43 patients,13 of whom had arterio-venous fistula (AVF)and 1 5 of whom had renal pseudoaneu-rysms (RAP).Among this 1 5 patients,there were 5 patients with arteriovenous fistula and one patiernt with artery-calyces fistula. Hemorrhage of tumor vessel was shown in 1 5 patients and renal arteriovenous malformation (RAVM)in 1.47 patients underwent renal artery CT arteriography before emergency interventional embolization.The hematuresis was completely stopped or significantly relieved in 82 of all patients.Only 3 patients with renal trauma and 2 patients with percutaneous nephroscope were still had haematu-ria.All patients were followed up for 2 years.The total effective rate of emergency interventional embolization treatment was 94.25%(82/87),and no serious complications were observed.Conclusion As a safe,effective and micro-invasive treatment,emergency in-terventional embolization therapy can be used to treat the acute renal hemorrhage effectively.It can keep the maximum renal func-tion.Though acute renal hemorrhage angiography may have different manifestations,the choice of embolic agents is the key to stop the symptom.Renal artery CTA before embolotherapy is important for the diagnosis and therapy of acute renal hemorrhage.