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 201...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.展开更多
Background:Percutaneous nephrolithotomy(PNL)is the gold standard to treat large or complex renal stones.Intrarenal pseudoaneurysm is a rare,yet clinically significant,complication of PNL.Case summary:A 58-year-old man...Background:Percutaneous nephrolithotomy(PNL)is the gold standard to treat large or complex renal stones.Intrarenal pseudoaneurysm is a rare,yet clinically significant,complication of PNL.Case summary:A 58-year-old man with a 3cm calculus in the lower calyx of the left kidney was operated on by PNL 3days before presentation to the emergency department.The patient presented with massive hematuria and dizziness.Upon presentation,the patient appeared uncomfortable and in distress.He was in hemorrhagic shock.The patient was resuscitated with intravenous fluids and blood transfusion.An urgent computed tomography scan showed multiple clots in the left renal pelvis and bladder with a retroperitoneal hematoma.The patient underwent angiography which revealed an inferior pole branch pseudoaneurysm.The pseudoaneurysm was treated by endovascular embolization with N-butyl-2-cyanoacrylate.No postoperative complications were seen.Conclusion:Selective renal artery embolization is an effective treatment for pseudoaneurysm post PNL with excellent outcomes.展开更多
文摘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.
文摘Background:Percutaneous nephrolithotomy(PNL)is the gold standard to treat large or complex renal stones.Intrarenal pseudoaneurysm is a rare,yet clinically significant,complication of PNL.Case summary:A 58-year-old man with a 3cm calculus in the lower calyx of the left kidney was operated on by PNL 3days before presentation to the emergency department.The patient presented with massive hematuria and dizziness.Upon presentation,the patient appeared uncomfortable and in distress.He was in hemorrhagic shock.The patient was resuscitated with intravenous fluids and blood transfusion.An urgent computed tomography scan showed multiple clots in the left renal pelvis and bladder with a retroperitoneal hematoma.The patient underwent angiography which revealed an inferior pole branch pseudoaneurysm.The pseudoaneurysm was treated by endovascular embolization with N-butyl-2-cyanoacrylate.No postoperative complications were seen.Conclusion:Selective renal artery embolization is an effective treatment for pseudoaneurysm post PNL with excellent outcomes.
