title: Renal Arterial Pseudoaneurysm and Renal Arteriovenous Fistula Following Partial Nephrectomy.
abstract: BACKGROUND
  Renal arterial pseudoaneurysm (RAP) and renal arteriovenous fistula (RAVF) are rare but can cause fatal bleeding.
  
  
  METHODS
  A retrospective review was conducted for patients undergoing partial nephrectomy (PN) in our department. The clinical features and treatment methods were analysed, and the relationships between RAP/RAVF and the surgical methods and R.E.N.A.L. score were investigated.
  
  
  RESULTS
  Eleven patients were diagnosed with RAP/RAVF (9 with RAP and 2 with RAVF). The incidence of RAP/RAVF after laparoscopic PN showed no significant difference compared to that after open PN (p = 0.47). A low R.E.N.A.L. score was present in 6 patients, while an intermediate/high score was present in the other 5 patients. The major clinical manifestations included haematuria and haemorrhagic shock, and the median time of occurrence was 8 days after the operation. Six patients underwent an ultrasound examination. Of the 4 patients who underwent enhanced CT, 2 patients were diagnosed with RAP. All 11 patients were diagnosed by renal angiography and were cured after super-selective arterial embolization. The serum creatinine levels before and after embolization showed no significant differences (p = 0.14).
  
  
  CONCLUSIONS
  RAP/RAVF may not have any relationship with the surgical procedure or R.E.N.A.L. score. Renal angiography and super-selective arterial embolization are the preferred methods for diagnosing and treating RAP/RAVF.
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, PR China.
authors.forename: Jinchao
authors.initials: J
authors.lastname: Chen
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.forename: Pengjie
authors.initials: P
authors.lastname: Wu
authors.forename: Teng
authors.initials: T
authors.lastname: Li
authors.forename: Xianghui
authors.initials: X
authors.lastname: Ning
authors.forename: Shuanghe
authors.initials: S
authors.lastname: Peng
authors.forename: Jiangyi
authors.initials: J
authors.lastname: Wang
authors.forename: Nienie
authors.initials: N
authors.lastname: Qi
authors.forename: Kan
authors.initials: K
authors.lastname: Gong
mesh_terms: D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis* / Q000209:etiology; D000792:Angiography; D001164:Arteriovenous Fistula / Q000175:diagnosis* / Q000209:etiology; D003404:Creatinine / Q000097:blood; D004621:Embolization, Therapeutic; D005260:Female; D006470:Hemorrhage / Q000601:surgery; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D012077:Renal Artery / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003404:Creatinine
keywords: Partial nephrectomy; Renal angiography; Renal arterial pseudoaneurysm; Renal arteriovenous fistula; Super-selective arterial embolization