[The role of superselective transcatheter arterial embolisation in management of complications after kidney surgery].
OBJECTIVE
Transcatheter arterial embolisation (TAE) is replacing open procedures in terms of vascular malformations or traumatic haemorrhage. Furthermore, the role of TAE is established in post-surgery bleeding complications. We report on a number of patients with severe haemorrhage after kidney surgery and successful management by TAE.


METHODS
Gross renal haemorrhage was observed after pyelocalicolithotomy and open kidney-sparing surgery. One patient developed a large arteriovenous fistula after kidney transplantation preceded by open biopsy. Technique of TAE: In all cases the bleeding vessel was located by transfemoral arteriography. Embolisation was performed by dropping platinum coils or gelfoam pellets.


RESULTS
TAE stopped the haemorrhage in all patients and occluded the arteriovenous fistula in the renal allograft. No complications were observed.


CONCLUSIONS
TAE can be considered as the treatment of choice for a widespread range of complications after kidney surgery. It should always be taken into consideration before open surgical revision.
Fechner
G
G
Klinik und Poliklinik für Urologie, Universitätsklinikum Bonn. guido.fechner@ukb.uni-bonn.de
Hauser
S
S
Flacke
S
S
Gerhard
T
T
Müller
S C
SC
D000328:Adult; D000792:Angiography; D001164:Arteriovenous Fistula / Q000628:therapy; D002292:Carcinoma, Renal Cell / Q000601:surgery; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply; D007669:Kidney Calculi / Q000601:surgery; D007674:Kidney Diseases / Q000601:surgery* / Q000628:therapy*; D007680:Kidney Neoplasms / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex