Rennert J, Herold T, Schreyer A G, Banas B, Jung E M, Feuerbach S, Lenhart M, Mueller-Wille R, Zorger N
Institut für Röntgendiagnostik, Klinikum der Universität Regensburg, Regensburg.
Rofo. 2009 Oct;181(10):996-1001. doi: 10.1055/s-0028-1109741. Epub 2009 Sep 24.
To evaluate the therapeutic outcome after endovascular treatment of renal vascular lesions using the liquid embolization agent, Onyx.
Between 2004 and 2008 nine patients with renal vascular lesions were treated with transcatheter arterial embolization using Onyx. The renal vascular lesions consisted of 4 AV-fistulas, a pseudoaneurysm, bleeding from a single subsegmental artery, diffuse parenchymal bleeding after trauma, septic embolizations and multiple aneurysms in endocarditis. All patients underwent selective angiography of the renal artery. A dimethyl sulfoxide (DMSO)-compatible microcatheter was used and Onyx was injected. The technical and clinical success rate, examination time and procedure-related complications were documented.
The overall technical and clinical success rate was 100 %. One patient had to be treated twice due to recurrent bleeding after an accidental puncture with a drainage catheter. No loss of viable renal tissue occurred in 4 cases. In 4 patients mild to moderate parenchyma loss was noted. In one patient having diffuse renal bleeding, occlusion of the main renal artery was performed. No procedure-related complications were noted. The mean examination time was 16.17 min when treating with Onyx alone and 60 min when using a combination of Onyx and coils. Within an average follow-up period of 21 months, no recurrent renal bleeding or recurrent AV-fistulas occurred.
Onyx is an effective embolization agent for the treatment of renal vascular lesions. It allows controlled and quick application with low complication rates and a short examination time as a standalone agent or in combination with coils.
评估使用液体栓塞剂Onyx对肾血管病变进行血管内治疗后的治疗效果。
2004年至2008年间，9例肾血管病变患者接受了使用Onyx的经导管动脉栓塞治疗。肾血管病变包括4例动静脉瘘、1例假性动脉瘤、单一亚段动脉出血、创伤后弥漫性实质出血、感染性栓塞以及心内膜炎中的多发动脉瘤。所有患者均接受了肾动脉选择性血管造影。使用了与二甲亚砜（DMSO）兼容的微导管并注入了Onyx。记录了技术成功率、临床成功率、检查时间及与操作相关的并发症。
总体技术成功率和临床成功率均为100%。1例患者因引流导管意外穿刺后反复出血而需接受两次治疗。4例未出现存活肾组织丢失。4例患者出现轻度至中度实质丢失。1例弥漫性肾出血患者进行了肾主动脉闭塞术。未发现与操作相关的并发症。单独使用Onyx治疗时平均检查时间为16.17分钟，使用Onyx与弹簧圈联合治疗时为60分钟。在平均21个月的随访期内，未出现复发性肾出血或复发性动静脉瘘。
Onyx是治疗肾血管病变的有效栓塞剂。作为单一药物或与弹簧圈联合使用时，它能够实现可控且快速的应用，并发症发生率低，检查时间短。
