DSA for Diagnosis and Transcatheter Arterial Embolization for the Treatment of Traumatic Renal Hemorrhage

Objective To evaluate the clinical value of DSA for the diagnosis and transcatheter arterial embolization for the treatment of traumatic renal hemorrhage.Materials and Methods 48 patents with traumatic renal hemorrhage had renal artery digital subtraction angiography(DSA).Embolization was performed with gelfoam,poly vinyl alcohol(PVA) particulate and spring steel coil respectively.Results All patients were confirmed by selective or super-selective renal arteriography.Contrast medium external eruption was observed in 36 cases.Injured renal artery twitched and shifted,and the distal vessels were irregular and foggy in 7 cases,3 of which had arteviovenors fistula.The branches of injured renal artery were broken off and missing in 5 cases,2 of which presented with false aneurysm.Hematuria occurred on the seventh day and the twelfth day respectively in 2 cases among 6 genlatin sponge-embolized cases.Other cases succeeded with embolization using poly vinyl alcohol particulate or spring steel coil.Hematuria ceased in 3 days on average.No recurrence of renal hemorrhage was found in 18 months.Blood creatinine,blood urea nitrogen and blood pressure were normal.The renal parenchyma without embolization worked normally while renal calyces of the embolized part were distorted under intravenous urography.Conclusion DSA is reliable for the diagnosis of traumatic renal hemorrhage.Selective renal arterial embolization for the treatment of traumatic renal hemorrhage is minimally invasive,effective,prompt with few of complications,and can preserve the function of traumatic renal mostly.Recurrence and embolization at the wrong place can be reduced by choosing right material for embolization.