Renal artery embolization in the treatment of urinary fistula after renal duplication:A case report and review of literature

BACKGROUND Duplicate renal malformation is a congenital disease of the urinary system,with an incidence rate of 0.8%.Surgical treatment is suitable for symptomatic patients.Urinary fistula is one of the complications of heminephrectomy.Long-term urinary fistula has a great impact on patients'lives.CASE SUMMARY This article mainly reports on a 47-year-old man with duplication of kidney deformity,long urinary fistula after partial nephrectomy,and no improvement after conservative treatment.We have achieved positive results in the arterial embolization treatment of the residual renal artery,indicating that selective arterial embolization is a good way to treat urinary fistula after partial nephrectomy.It is worth noting that this patient violated the Weigert-Meyer law,which also gave us more consideration.CONCLUSION Renal artery embolization may be a simple and safe method to treat urinary fistula inefficacy with conservative treatment.

Application of super-selective renal artery embolization in renal injuries

Objective: To use super selective renal artery embolization in treatment of patients with renal injuries. Methods: From 1991 to 1998, 11 cases of renal injuries due to different causes underwent super selective renal artery embolization. In these patients, 91% of injury sites were segmental arteries and their branches. All the patients were treated with steel coil for embolization. Results: Nine patients showed prompt cessation of hematuria, and in 2 patients hematuria stopped 2 4 days after embolization. Conclusions: Super selective renal artery embolization (SSRAE) is suitable for severe hematuria, limited size of kidney injuries, stable hemodynamic parameters after conservative treatment and low reserve of renal function. Steel coil is an effective embolic material, rapid hemostasis can be fulfilled and renal function can be reserved. Super selective renal artery embolization has low incidence of complications and can shorten hospitalization time.

Surgical treatment of left-sided renal carcinoma with grade II inferior vena cava tumour thrombus: a report and review of the literature

The surgical removal of renal cancer,along with the thrombectomy of the inferior vena cava tumour thrombus,represents a remarkable milestone in urological surgery.This procedure is not only technically demanding but also requires a high level of surgical expertise.Managing renal cancer combined with a vena cava tumour thrombus poses significant challenges,especially when dealing with combined grade Ⅱ-Ⅳ inferior vena cava tumour thrombus.The complexity of these cases is further exacerbated by the delicate anatomical structures involved and the need to preserve critical vessels while effectively removing the tumour.The Upper Urethral Tumour Treatment Centre of Weifang People's Hospital successfully treated a challenging case of left renal tumour combined with grade II inferior vena cava tumour thrombus.The surgical team,led by experienced urological surgeons,meticulously planned and executed the procedure,ensuring minimal trauma to the patient and complete removal of the tumour.This achievement not only demonstrates the hospital's commitment to providing state-of-the-art surgical care but also highlights the importance of continued research and training in urological oncology.The successful outcome of this case is a testament to the expertise and dedication of the medical team and offers hope to patients facing similar complex surgical challenges.

Percutaneous transcatheter super-selective renal arterial embolization with N-butyl cyanoacrylate for iatrogenic renal hemorrhage

Background:To evaluate the safety and efficacy of percutaneous transcatheter super-selective renal arterial embolization(SRAE)with N-butyl cyanoacrylate(NBCA)for iatrogenic renal hemorrhage.Methods:Between January 2014 and December 2019,45 patients(including 18 patients with coagulopathy),who underwent percutaneous transcatheter SRAE with NBCA for iatrogenic renal hemorrhage at our institution,were retrospectively reviewed.The technical success rate,clinical success rate,and embolization-related complications were analyzed.The values of estimated glomerular filtration rate(eGFR),serum creatinine(sCr),and serum urea(sUr)were analyzed at the time of pre-SRAE,post-SRAE,and last follow-up to evaluate the effects of NBCA-based SRAE on renal function.Results:Diagnostic renal arteriography revealed contrast extravasation in 18 patients and pseudoaneurysms in 27 patients.NBCA mixed with iodized oil in a 1:2–1:4 ratio was the sole embolic agent.No procedure-related mortality or major complications occurred.The technical and clinical success rates were both 100%.The values of eGFR,sCr and sUr were not found to be significantly different between pre-SRAE,post-SRAE and last follow-up(eGFR:91.52±21.17 vs.90.98±22.11 vs.92.14±23.51 mL/min/1.73 m^(2),p=0.729;sCr:74.73±11.08 vs.75.27±12.43 vs.73.95±10.14μmol/L,p=0.543;sUr:5.69±0.84 vs.5.71±0.96 vs.5.70±0.79,p=0.515,respectively).Conclusions:Percutaneous transcatheter SRAE with NBCA is a safe and effective treatment modality for iatrogenic renal hemorrhage with no deterioration of renal function.

Safety and efficacy of Endovascular Management of high-grade blunt renal injury

Objectives:To provide data on the safety and efficacy of renal arterial embolization(RAE)in patients with highgrade blunt renal injury.Materials and methods:Fifteen patients with high-grade blunt renal injury(AAST grades IV-V)admitted to our hospital from July 2014 to December 2019 were retrospectively reviewed in this study.Their clinical success rate and complications were investigated accordingly.Results:Fifteen patients with high-grade blunt renal injury,13 men and 2 women with an average age of 41.6 years,including 11 hemodynamically unstable patients and 4 stable patients,were treated with RAE.Among these patients,73.3%(11 of 15)had grade IV,and 26.7%(4 of 15)had grade V injuries,while 53.3%(8 of 15)patients had concomitant injuries.One patient received main RAE and 14 patients received selective RAE.The clinical success rate after the first embolization was 93.3%(14 of 15).RAE was repeated and was successfully performed in one patient with sustained hematuria.No significant difference in creatinine levels was found before and after embolization.During the follow-up period of 2–82 months,two patients required tube drainage due to urine leaks,one patient developed renal failure requiring renal replacement therapy,and one patient developed secondary hypertension.Conclusions:RAE can provide a high success rate of hemostasis for both hemodynamically stable and unstable patients with high-grade blunt renal injury,and only minor complications are observed with this procedure.

Renal arterial embolization:Indications,angiographic findings,and outcomes in a series of 170 patients

Background:The lack of overall experience and reporting on angiographic findings in previously published studies of renal arterial embolization(RAE)compelled us to report our overall experience on a series of patients.Materials and methods:A retrospective study was performed analyzing data of patients enrolled for RAE between 2010 and 2019.History,physical examination,and laboratory data were reviewed for all patients.Abdominal ultrasound was the initial imaging study,and all patients underwent subsequent computed tomography or magnetic resonance imaging.The outcome of RAE was determined based on radiographic and clinical findings.Results:Data from 202 patients were analyzed,with a mean age of 45±15 years,and 71.3%of patients were male.Iatrogenic injury was the most common indication for RAE(54%),followed by renal tumors,trauma,and spontaneous,in 27.7%,10.4%,and 8.4%of patients,respectively.Renal angiography revealing pseudoaneurysm alone or with other pathology in the lower pole of the kidney was the most common finding(40.6%),whereas no lesions were identified on angiography in 32 patients(15.8%),after which RAE was subsequently aborted.Renal arterial embolization was successful in 158 of 170 patients(92.9%)after 1 or more trials(maximum of 4).Microcoil alone or with other embolic materials was the most commonly used material for embolization(85%).Conclusions:latrogenic injury was the most common indication for RAE.Pseudoaneurysm alone or with other lesions was the most common lesion on renal angiography;however,angiography showed a negative result in 16%of patients,even those with symptoms.When lesions are present on angiography,the overall success of repeated trials of RAE reached 92.9%.

nterventional Therapy for Bilateral Acute Renal Artery Embolism Caused by Paroxysmal Atrial Fibrillation

Clinically persistent atrial fibrillation （AF） occurring with systemic embolism is not uncommon. In contrast, the incidence of embolism due to paroxysmal AF is far lower than that of persistent AF. Cerebral arteries are the most common sites of emboli caused by AF, followed by the mesenteric artery, splenic artery, lower extremity arteries, and renal arteries. However, the occurrence of concurrent bilateral renal artery emboli is extremely rare in paroxysmal AF patients. Within the scope of the information, we have collected, only three similar cases have been reported.