[Persistent renal bleeding treated with selective vascular embolisation with preservation of renal function].
In three patients with persistent blood loss from bleeding or abnormal renal vessels, kidney function was preserved by treatment with selective embolisation. The first patient, a 42-year-old woman, suffered from persistent haematuria after undergoing percutaneous nephrolithotripsy on the left side. Because conservative methods had failed and renal artery bleeding as a result of the lithotripsy was suspected, angiography with selective coil embolisation of a segmental branch of the lower pole artery of the kidney was performed. The second patient, a 40-year-old man with severe haemophilia A had been suffering from recurring macroscopic haematuria for a few months. CT showed an arteriovenous malformation in the right kidney. Angiography in combination with embolisation with two detachable balloons resulted in occlusion of the malformation. The third patient, a 23-year-old woman with tuberous sclerosis, presented with left abdominal pain, haematuria and decreasing haemoglobin concentrations. CT revealed a left renal angiomyolipoma, 10 cm in size, with a large internal haematoma. Three pathological branches of the upper pole renal artery were successfully occluded with Gianturco coils. At follow-up after 2, 2.5 and 2.5 years respectively, no recurrence of bleeding had occurred. Selective embolisation should be attempted as means of treatment for persistent renal bleeding if conservative treatment fails. Selective embolisation is minimally invasive and has the important advantage of preserving renal function.
Lazarov
R
R
Afd. Urologie, Universitair Medisch Centrum, Heidelberglaan 100, 3584 CX Utrecht. r.j.a.vanmoorselaar@chir.azu.nl
de Kort
G A P
GA
van Moorselaar
R J A
RJ
D000328:Adult; D018207:Angiomyolipoma / Q000150:complications; D001165:Arteriovenous Malformations / Q000150:complications / Q000628:therapy; D021721:Balloon Occlusion; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000150:complications; D006417:Hematuria / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000502:physiology; D007680:Kidney Neoplasms / Q000150:complications; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D012077:Renal Artery / Q000293:injuries; D055502:Secondary Prevention
Persisterend renaal bloedverlies behandeld door selectieve vasculaire embolisatie, met behoud van nierfunctie.