Transcatheter Endovascular Embolization of Biopsy Related Renal Vascular Injuries

Objective To evaluate the efficacy and safety of the interventional techniques for treatment of biopsy-related renal injury.Materials and Methods 7 patients with biopsy-related renal vascular injuries were treated with superselective arterial embolization. The embolization devices were microcoils in 6 patients and standard stainless steel coils in 1 patient, associated with polyvinyl alcohol particles (PVA) in 3 cases.Results Renal angiogram revealed the intra-renal arteriovenous fistula in 4 cases, the contrast media extravasation in 2 patients, and an intrarenal pseudoaneurysm in 1 patient. The technical success (100%) of the arterial embolization was achieved in all 7 cases in a single session. Angiography documented complete obliteration of the abnormal vessels without other major intrarenal arterial branch occlusion after embolization. 5 patient with hemodynamically compromise experienced immediate relief of their blood loss related symptoms, and cases with severe flank pain were relieved in 2～5 days after embolization. Hematuria in 7 patients were disappeared in 2～7 days after the embolization. 1 patient was suffered acute renal main artery thrombotic occlusion immediately after the embolization, and he was successfully treated with local thrombolysis. The renal function was worse after the procedures in 3 cases,including transient worse (n=2) or developed new (n=1) renal dysfunction. 1 of them required hemodialysis. The patients with perirenal hematoma were disappeared confirmed by ultrasonography in 2～3 months after the procedures. Follow-up time ranged from 10～68 months (mean 36 months), 2 patients died of primary the renal disease(chronic renal disfunction and lymphnoma 1 case respectively), 5 patients were still alive without further intervention, and both re-bleeding and deterioration of renal function did not occur.Conclusion Transcatheter embolization is a safe and effective endovascular technique to treat biopsy-related renal vascular injuries.