title: Endovascular management of iatrogenic renal arterial lesions and clinical outcomes.
abstract: OBJECTIVE
  We aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous fistula, and arteriocaliceal fistula, their management by endovascular embolization, and the clinical results.
  
  
  METHODS
  Fifty-five patients (forty males, fifteen females) with a median age of 40 years (range, 8-85 years), who underwent endovascular embolization of iatrogenic renal arterial lesions between March 2003 and December 2013 were included in this retrospective study. Types of iatrogenic lesions and details of embolization procedures were reported. Estimated glomerular filtration rate (eGFR), renal function tests, hemoglobin, and hematocrit levels before and after embolization were recorded and compared.
  
  
  RESULTS
  Median follow-up was 24 months. We identified 53 pseudoaneurysms, 30 arteriovenous fistulas, and 11 arteriocaliceal fistulas in 55 patients, after percutaneous nephrolithotomy (n=26), renal biopsy (n=21), nephrostomy (n=3), renal surgery (n=3), and extracorporeal shock wave lithotripsy (n=2). Median number of pseudoaneurysms was 1 (range, 1-4) with a median size of 7 mm (range, 1.5-35 mm). Fifty-one patients underwent coil embolization. Median number of coils was 5 (range, 2-21) and median renal parenchymal loss was 5% (range, 1%-50%). There were no significant differences between pre- and postoperative eGFR and serum parameters.
  
  
  CONCLUSIONS
  Iatrogenic renal arterial lesion can be a life threatening condition. Superselective coil embolization is a safe, minimally invasive treatment option with minimal renal parenchymal loss and without significant change in renal function.
authors.affiliation: Department of Radiology, Bülent Ecevit University School of Medicine, Zonguldak, Turkey. serkanguneyli@yahoo.com.
authors.forename: Serkan
authors.initials: S
authors.lastname: Güneyli
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gök
authors.forename: Halil
authors.initials: H
authors.lastname: Bozkaya
authors.forename: Celal
authors.initials: C
authors.lastname: Çınar
authors.forename: Arastu
authors.initials: A
authors.lastname: Tizro
authors.forename: Mehmet
authors.initials: M
authors.lastname: Korkmaz
authors.forename: Yiğit
authors.initials: Y
authors.lastname: Akın
authors.forename: Mustafa
authors.initials: M
authors.lastname: Parıldar
authors.forename: İsmail
authors.initials: İ
authors.lastname: Oran
mesh_terms: D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000097:blood / Q000628:therapy; D001164:Arteriovenous Fistula / Q000097:blood / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007668:Kidney / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D007670:Kidney Calices / Q000002:abnormalities* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000002:abnormalities* / Q000473:pathology; D012082:Renal Veins / Q000002:abnormalities / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome
references.citation: Cardiovasc Intervent Radiol. 2012 Dec;35(6):1340-5
references.pmid: 22170507
references.citation: Cardiovasc Intervent Radiol. 2009 Jan;32(1):163-5
references.pmid: 18389183
references.citation: Urology. 2001 Jul;58(1):105
references.pmid: 11445492
references.citation: Interv Med Appl Sci. 2013 Jun;5(2):81-4
references.pmid: 24265895
references.citation: BJU Int. 2007 Apr;99(4):881-6
references.pmid: 17166242
references.citation: J Urol. 1998 Sep;160(3 Pt 1):674-8
references.pmid: 9720519
references.citation: J Urol. 2011 Jun;185(6):2061-5
references.pmid: 21496835
references.citation: Ann Intern Med. 1999 Mar 16;130(6):461-70
references.pmid: 10075613
references.citation: J Endourol. 2007 Mar;21(3):330-3
references.pmid: 17444781
references.citation: Singapore Med J. 2008 Jan;49(1):63-6
references.pmid: 18204772
references.citation: Asia Pac Allergy. 2013 Oct;3(4):241-8
references.pmid: 24260729
references.citation: Int J Urol. 2005 Jul;12(7):683-5
references.pmid: 16045563
references.citation: J Urol. 2005 Jan;173(1):42-7
references.pmid: 15592022
references.citation: Radiographics. 2007 Jul-Aug;27(4):1109-30
references.pmid: 17620470
references.citation: Eur Radiol. 2011 Dec;21(12):2527-41
references.pmid: 21866433
references.citation: Urology. 2009 Oct;74(4):819-23
references.pmid: 19647302
references.citation: J Endourol. 2008 Jun;22(6):1129-35
references.pmid: 18498232
references.citation: J Endourol. 2011 Jan;25(1):11-7
references.pmid: 21247286
references.citation: Eur J Vasc Endovasc Surg. 2003 Apr;25(4):296-304
references.pmid: 12651166
references.citation: Urology. 2003 Aug;62(2):227-31
references.pmid: 12893324
references.citation: AJR Am J Roentgenol. 2005 May;184(5):1661-4
references.pmid: 15855135
references.citation: Curr Opin Urol. 2001 May;11(3):281-6
references.pmid: 11371781
references.citation: Clin Radiol. 2007 Nov;62(11):1104-9
references.pmid: 17920871
references.citation: Urology. 2005 Jul;66(1):38-40
references.pmid: 15992882
references.citation: Urology. 2011 Oct;78(4):820-6
references.pmid: 21813164
references.citation: J Endourol. 2010 Jan;24(1):149-54
references.pmid: 19954351
references.citation: Urol Int. 2000;64(4):223-5
references.pmid: 10895090
references.citation: Emerg Radiol. 2008 Mar;15(2):119-22
references.pmid: 17593408
references.citation: J Endourol. 2006 Jun;20(6):405-9
references.pmid: 16808653
references.citation: J Urol. 2005 Dec;174(6):2256-9
references.pmid: 16280793