Transarterial glue embolization in iatrogenic renovascular injuries.
Iatrogenic injuries of the intrarenal arterial system include pseudoaneurysms and fistulas. They can cause hematuria and life-threatening hemodynamic instability, and therefore should be treated promptly. Endovascular treatment is recommended for these cases due to its effectiveness. Among the different agents used for embolization, n-butyl-2-cyanoacrylate (glue) has rarely been used. We present 15 patients with pseudoaneurysms and/or arteriovenous or caliceal fistulas who were treated by glue embolization. In our patient group, five had a history of percutaneous nephrolithotomy, six had renal biopsies, three had nephron-sparing surgery, and one had percutaneous nephrostomy. Glue embolizations were performed with the microcatheter technique. All patients were successfully treated, and all but one had excellent follow-ups. One patient suffered from disseminated intravascular coagulation secondary to transfusion and died after the procedure. We think glue embolization is a safe and effective treatment for this group of patients and present our experience along with the technical approach.
Cimsit
Nuri Cagatay
NC
Faculty of Medicine, Department of Radiology, Marmara University, Istanbul, Turkey. cagataycimsit@yahoo.com
Baltacioglu
Feyyaz
F
Cengic
Ismet
I
Akpinar
Ihsan Nuri
IN
Ilker
Yalçin
Y
Turkeri
Levent
L
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D006801:Humans; D007049:Iatrogenic Disease; D007668:Kidney / Q000098:blood supply* / Q000601:surgery; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D015641:Radiography, Interventional; D016896:Treatment Outcome
D004659:Enbucrilate