Angiographic diagnosis and selective renal artery embolization for traumatic intrarenal vascular injuries

Objective:To explore the value of angiographic diagnosis and clarify the therapeutic effect,indications and some experiences of selective renal artery embolization for traumatic intrarenal vascular injuries.Methods:Sixteen patients with traumatic intrarenal vascular injuries (13 men,3 woman;aged from 9～47years;average age,30.5±11.8 years) underwent angiography and interventional therapy were analyzed retrospectively.All patients underwent angiographic examinations and the definete diagnosis before the selective renal artery embolization.Embolization materials used in this study were gelfoam and steel coils.Results:Of the 16 patients who underwent angiography,all of them had positive findings:12 cases with contrast medium extravasated (together with renal artery pseudoaneurysm and/or arteriovenous fistula in 6 of them),9 cases with renal artery pseudoaneurysm (together with arteriovenous fistula in 3 of them) and 1 cases with arteriovenous fistula alone.The correct diagnoses were obtained through the angiography.There were 7 cases embolized with steel coils,3 with galfoam,6 with steel coils and gelfoam.All of them were performed successfully.Nine patients were no recurrence of haematuria with a mean follow-up of 14 months (range from 3～25 months).Conclusion:Angiography is one of the ideal and reliable methods used to diagnose and guide the interventional treatment for the traumatic intrarenal vascular injuries,and the selective renal artery embolization is a micro-traumatic and effective way for the traumatic intrarenal vascular injuries.