[Evaluation of a liquid embolization agent (Onyx) for transcatheter embolization for renal vascular lesions].
OBJECTIVE
To evaluate the therapeutic outcome after endovascular treatment of renal vascular lesions using the liquid embolization agent, Onyx.


METHODS
Between 2004 and 2008 nine patients with renal vascular lesions were treated with transcatheter arterial embolization using Onyx. The renal vascular lesions consisted of 4 AV-fistulas, a pseudoaneurysm, bleeding from a single subsegmental artery, diffuse parenchymal bleeding after trauma, septic embolizations and multiple aneurysms in endocarditis. All patients underwent selective angiography of the renal artery. A dimethyl sulfoxide (DMSO)-compatible microcatheter was used and Onyx was injected. The technical and clinical success rate, examination time and procedure-related complications were documented.


RESULTS
The overall technical and clinical success rate was 100 %. One patient had to be treated twice due to recurrent bleeding after an accidental puncture with a drainage catheter. No loss of viable renal tissue occurred in 4 cases. In 4 patients mild to moderate parenchyma loss was noted. In one patient having diffuse renal bleeding, occlusion of the main renal artery was performed. No procedure-related complications were noted. The mean examination time was 16.17 min when treating with Onyx alone and 60 min when using a combination of Onyx and coils. Within an average follow-up period of 21 months, no recurrent renal bleeding or recurrent AV-fistulas occurred.


CONCLUSIONS
Onyx is an effective embolization agent for the treatment of renal vascular lesions. It allows controlled and quick application with low complication rates and a short examination time as a standalone agent or in combination with coils.
Institut für Röntgendiagnostik, Klinikum der Universität Regensburg, Regensburg. jarennert@yahoo.de
J
J
Rennert
T
T
Herold
A G
AG
Schreyer
B
B
Banas
E M
EM
Jung
S
S
Feuerbach
M
M
Lenhart
R
R
Mueller-Wille
N
N
Zorger
D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy; D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D004621:Embolization, Therapeutic / Q000379:methods*; D004697:Endocarditis, Bacterial / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000008:administration & dosage*; D015642:Radiology, Interventional / Q000379:methods*; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000293:injuries; D014057:Tomography, X-Ray Computed
C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide