Hyperselective renal artery embolisation in the treatment of post-traumatic iatrogenic haematuria: report of two cases.
Angiography and selective renal artery embolisation were performed in two patients with post-traumatic iatrogenic kidney lesions and intractable haematuria. One patient presented after a nephrolithotomy with rupture of a segmental branch of the renal artery well demonstrated on selective angiography which showed intraparenchymal extravasion of contrast medium. The other presented after a renal biopsy with severe haematuria. Angiography performed 10 days later demonstrated an arteriovenous fistula at the site of the puncture. Hyperselective embolisation achieved immediate control of the haematuria in both patients, with maximal preservation of the renal parenchyma and maintenance of good renal function. At follow-up 12 months later, there had been no recurrence of the haematuria. These results suggest that transcatheter embolisation should be considered the method of first choice in renal trauma accompanied by intractable haematuria before any surgery is attempted.
Tzortzis
G
G
Department of Radiology, Laikon General Hospital of Athens, Greece.
Kolomodi
D
D
Stathopoulou
S
S
Kostakis
A
A
Michail
S
S
Pappas
P
P
Revenas
K
K
D001164:Arteriovenous Fistula / Q000209:etiology; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006417:Hematuria / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D007049:Iatrogenic Disease; D007668:Kidney / Q000293:injuries; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D012077:Renal Artery / Q000293:injuries; D012082:Renal Veins