[Percutaneous embolization of the kidney: indications and clinical results].
OBJECTIVE
Renal embolisation offers a minimal invasive means of renal ablation under primary palliative indication. We evaluated our experience with this technique in a series of 40 patients.


METHODS
From 1996 to 2002 a total of 40 patients underwent total embolisation of the kidney. Our patients encompassed 15 females and 25-males (median age: 68 years, 46 - 89 years). In 15 patients indication for embolisation was to ablate a non-functioning kidney following obstruction due to advanced cancer, in 9 patients preoperatively with advanced renal cell carcinomas invading the vena cava, in 8 patients for control of hematuria and in 8 patients with non-operable advanced renal cancers. The embolisation was carried out in DAS-technique with a 7 Fr. selective catheter and central placement of macrocoils, from 2000 on we additionally performed a peripheral embolisation with polyvinylalcohol (PVA) particles. The intervention took place in epidural anesthesia.


RESULTS
Perioperatively in all patients a complete occlusion of the renal artery as well as acessory arteries (n = 6) could be documented radiographically, perioperative complications were not observed. A post-embolisation syndrome occured in 32 patients. Reinterventions with repeat embolisation became necessary in 5 patients (persistent urine production-n = 4, persistent hematuria-n = 1).


CONCLUSIONS
The combined central and peripheral embolisation of the kidney in epidural anesthesia is a valuable means in selected patients under palliative indication for defunctionalisation of the kidney as well as control of hematuria.
Fichtner
J
J
Urologische Klinik, Evangelisches und Johanniter Klinikum Duisburg/Dinslaken/Oberhausen. jan.fichtner@ejk.de
Swoboda
A
A
Hutschenreiter
G
G
Neuerburg
J
J
D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural; D002292:Carcinoma, Renal Cell / Q000601:surgery / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D006417:Hematuria / Q000628:therapy; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D010166:Palliative Care; D018579:Patient Selection; D011300:Preoperative Care; D012077:Renal Artery