title: Superselective renal artery embolization in the treatment of renal hemorrhage.
abstract: BACKGROUND
  Renal hemorrhage is a potentially life-threatening event that may follow trauma, operation, biopsy, and sudden spontaneous rupture of renal tumors or aneurysms. Superselective renal artery embolization (SRAE) is a well-established method for such cases.
  
  
  OBJECTIVE
  To assess the effectiveness of SRAE in the treatment of renal hemorrhage at our institute.
  
  
  METHODS
  We respectively reviewed the medical records of patients who underwent SRAE for renal hemorrhage from January 2005 to June 2012. Data on patients' characteristics, indications, requirement of pre-embolization blood transfusion, angiographic finding, location of bleeding site, embolization agents, post-embolization transfusion requirement, complications and the outcome were recorded.
  
  
  RESULTS
  A total of 46 patients, aged 26-73 years, underwent SRAE because of hemorrhage after percutaneous nephrolithotomy (n = 25), partial nephrectomy (n = 6), renal biopsy (n = 2), trauma (n = 2), rupture of angiomyolipoma (n = 4), renal aneurysm (n = 1), and renal ateriovenous malformations (n = 6). A total of 41 patients (80.8 %) underwent successful embolization. Treatment failed in 5 patients with hemorrhage caused by percutaneous nephrolithotomy. Of these, four patients underwent a secondly superselective embolization and had a successful outcome. The remaining one was managed by conservative therapy with repeated blood transfusions. No patient required nephrectomy to save the life of the patient. No serious procedure-related complications occurred.
  
  
  CONCLUSIONS
  SRAE is an effective and minimal invasive method for the control of renal hemorrhage. Our experience strongly recommended the first-line use of SRAE for severe renal hemorrhage.
authors.affiliation: Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, 310003, Zhejiang Province, China.
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: Q
authors.initials: Q
authors.lastname: Mao
authors.forename: F
authors.initials: F
authors.lastname: Tan
authors.forename: B
authors.initials: B
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000293:injuries; D012189:Retrospective Studies; D016896:Treatment Outcome