Super-selective renal artery embolization for the treatment of acute renal hemorrhage

Objective To evaluate super-selective renal artery embolization in treating acute renal hemorrhage.Methods A total of 17 patients with massive renal bleeding were enrolled in this study.After super-selective renal artery catheterization with 4 F and/or 2.7 F catheter was accomplished,renal artery embolization with microcoils,coils and/or PVA particles was carried out.Preoperative CTA was performed in five patients.Plain CT scanning and contrast-enhanced CTA were employed in nine patients at 4 days to 54 months after treatment.Results Technical success was achieved in all of the 17 cases.Pre-interventional CT scan showed abnormal signs of hemorrhage,arteriovenous malformation,aneurysm,etc.Post-interventional CT scan showed different degrees of renal infarction,renal atrophy,peripheral contraction and depression of the kidney which were located in the areas originally supplied by embolized artery.Compensatory hypertrophy of the contralateral normal kidney occurred in four cases.Abnormal blood vessels disappeared in post-interventional CTA.No coil displacement was seen.Conclusion For the treatment of acute renal hemorrhage super-selective renal artery embolization is safe and reliable.CTA is of great significance for identifying the bleeding sites before interventional treatment and for evaluating the therapeutic effect.