title: Percutaneous embolization of iatrogenic arterial kidney injuries: safety, efficacy, and impact on blood pressure and renal function.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of percutaneous renal artery embolization (RAE) of iatrogenic vascular kidney injuries and the effects of RAE on renal function and arterial blood pressure (BP).
  
  
  METHODS
  Over a 12-year period, 50 consecutive patients with severe hemorrhage after iatrogenic arterial kidney injuries underwent RAE. Technical success was defined as occlusion of the bleeding site, and clinical success was defined as complete bleeding cessation. The effects on renal function and arterial BP were assessed by comparing the estimated glomerular filtration rate (eGFR), renal function stage (National Kidney Foundation scale), systolic BP, and BP stage (European Society of Hypertension classification) before and after RAE.
  
  
  RESULTS
  RAE was technically successful in 49 patients (98%). Two patients were lost to follow-up after RAE. Clinical success was obtained in 40 (83%), 45 (94%), and 47 patients (98%), respectively, at 24, 48, and 96 hours after RAE. Three patients (6%) had minor complications, and one patient (2%) died within 30 days after RAE. Follow-up renal function data (mean, 4 mo) were available for 33 patients (66%). No statistically significant differences in eGFR (P = .186) or renal function stage (P = .183) were apparent after RAE. Follow-up BP data (mean, 3 mo) were available for 28 patients (56%). There were no significant differences in systolic BP (P = .233) or BP stage (P = .745) after RAE.
  
  
  CONCLUSIONS
  Embolization of iatrogenic renal artery injuries is safe and associated with high technical and clinical success rates. It is not associated with a significant worsening of renal function or increase in BP.
authors.affiliation: Department of Radiology, Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Hôtel-Dieu, 3840 St. Urbain St., Montreal, QC, Canada H2W 1T8.
authors.forename: Karl
authors.initials: K
authors.lastname: Sam
authors.forename: Gérald
authors.initials: G
authors.lastname: Gahide
authors.forename: Gilles
authors.initials: G
authors.lastname: Soulez
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Giroux
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Oliva
authors.forename: Pierre
authors.initials: P
authors.lastname: Perreault
authors.forename: Louis
authors.initials: L
authors.lastname: Bouchard
authors.forename: Patrick
authors.initials: P
authors.lastname: Gilbert
authors.forename: Eric
authors.initials: E
authors.lastname: Therasse
mesh_terms: D001794:Blood Pressure; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D005919:Glomerular Filtration Rate; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007049:Iatrogenic Disease; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D011792:Quebec; D012077:Renal Artery / Q000293:injuries* / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*