Ginat Daniel T, Saad Wael E A, Turba Ulku C
Department of Imaging Science and Interventional Radiology, University of Rochester Medical Center, Rochester, NY 14642-8648, USA.
Tech Vasc Interv Radiol. 2009 Dec;12(4):224-39. doi: 10.1053/j.tvir.2009.09.007.
Renal artery embolization is a minimally invasive procedure that is increasingly being used for treatment of a wide range of conditions. The main indications for renal artery embolization include (1) prenephrectomy and preradiofrequency ablation infarction of renal tumors, (2) management of renal angiomyolipomas, (3) palliations of unresectable renal malignancy, (4) renal hemorrhage (life-threatening or chronic debilitating hematuria), (5) arteriovenous fistulas, (6) vascular malformations, (7) renal artery aneurysms and pseudoaneurysms, and other less common indications, such as severe hydronephrosis and hypertension. A variety of embolic materials are available, such as metal coils, sclerosants (glue, Onyx, absolute ethanol, lipiodol), and particulate embolic agents (polyvinyl alcohol particles and embospheres). Selection of the appropriate agent depends on the clinical application, technical and clinical endpoints, as well as the pathology lesion(s) targeted. Renal artery embolization can be performed alone or in combination with remodeling techniques, stent-grafting, and balloon- or stent-assisted coiling in more complicated cases. The procedure is generally regarded as safe and effective for diverse applications and is considered as an evolving area in the field of endoluminal therapy.
肾动脉栓塞术是一种微创操作，越来越多地用于治疗多种病症。肾动脉栓塞术的主要适应证包括：（1）肾肿瘤术前及射频消融术前梗死；（2）肾血管平滑肌脂肪瘤的治疗；（3）不可切除性肾恶性肿瘤的姑息治疗；（4）肾出血（危及生命或慢性致残性血尿）；（5）动静脉瘘；（6）血管畸形；（7）肾动脉动脉瘤和假性动脉瘤，以及其他不太常见的适应证，如严重肾积水和高血压。有多种栓塞材料可供使用，如金属线圈、硬化剂（胶水、Onyx、无水乙醇、碘油）和颗粒栓塞剂（聚乙烯醇颗粒和栓塞球）。选择合适的栓塞剂取决于临床应用、技术和临床终点以及目标病理病变。肾动脉栓塞术可单独进行，或在更复杂的病例中与重塑技术、支架植入术以及球囊或支架辅助弹簧圈栓塞术联合进行。该操作通常被认为对多种应用是安全有效的，并且被视为腔内治疗领域一个不断发展的领域。
