Embolization of iatrogenic vascular injuries of renal transplants: immediate and follow-up results.
OBJECTIVE
To evaluate the outcome in seven patients in whom iatrogenic vascular complications were treated with catheter embolization.


METHODS
Angiography showed an arteriovenous fistula in six of the seven patients, a pseudoaneurysm in three patients, and an arteriocaliceal fistula in three patients. Embolization was performed with GAW coils or microcoils in all cases. In three patients enbucrilate, polyvinyl alcohol, or absorbable gelatin powder was administered as an adjunct to the coils.


RESULTS
Angiographic success with total occlusion of the vascular injury was achieved in five of the seven patients and clinical success was achieved in four of seven cases. In two cases, nephrectomy after embolization was necessary because of renal artery occlusion or acute hemorrhage at the renal artery anastomosis, respectively. Infarction of 30%-50% of the renal parenchyma was seen in two cases.


CONCLUSIONS
Angiographically successful embolization is not necessarily associated with clinical success. The complication rate is high.
Dorffner
R
R
Department of Radiology, University of Vienna, AKH, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Thurnher
S
S
Prokesch
R
R
Bankier
A
A
Turetschek
K
K
Schmidt
A
A
Lammer
J
J
D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D001707:Biopsy, Needle / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000293:injuries*; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy