Successful renal transcatheter arterial embolization in three patients with symptomatic hydronephrosis due to ureteral obstruction.
BACKGROUND
Conventional treatments for symptomatic enlargement of a nonfunctional hydronephrotic kidney caused by obstructive uropathy include surgical treatments.


METHODS
Patients included a 67-year-old woman whose obstruction was caused by a lower urinary tract stone complicating spinal tuberculosis (patient 1); a 52-year-old man with compressive complete congenital obstruction crossing the ureteropelvic junction from an aberrant renal artery (patient 2); and a 19-year-old woman with essentially complete idiopathic congenital obstruction at the ureteropelvic junction (patient 3), who required antibiotics for pyelonephritis before embolization. The renal artery was embolized using platinum microcoils.


RESULTS
Although the sensation of abdominal fullness diminished within approximately two week after TAE, it took one to two years until the embolized kidney size shrank from 1377+/-634 cm3 (range, 829 to 2072) to 43+/-46 cm3 (42 to 94) by the evaluation of computed tomography. Fever after embolization persisted for 5 days in patient 1, 3 in patient 2, and 9 in patient 3. Flank pain resolved within 5 days in all. Pyelonephritis and complications of treatment have not occurred.


CONCLUSIONS
Embolization for this indication was safe and effective.
Ubara
Yoshifumi
Y
Nephrology Center, Toranomon Hospital, Kajigaya, Kawasaki.
Tagami
Tetsuo
T
Higa
Yasushi
Y
Suwabe
Tatsuya
T
Nomura
Kazufumi
K
Hoshino
Jyunichi
J
Sawa
Naoki
N
Katori
Hideyuki
H
Takemoto
Fumi
F
Hara
Shigeko
S
Takaichi
Kenmei
K
D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D021501:Flank Pain / Q000209:etiology; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000209:etiology / Q000628:therapy*; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging; D014517:Ureteral Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*