Department of Urology, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou, People's Republic of China.
Department of Urology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, People's Republic of China.
Ther Clin Risk Manag. 2014 Jun 16;10:455-8. doi: 10.2147/TCRM.S59671. eCollection 2014.
To explore the therapeutic efficacy and outcome of superselective transcatheter renal artery embolization for the treatment of hemorrhage from non-iatrogenic blunt renal trauma (BRT).
Sixteen patients who received superselective transcatheter renal artery embolization for non-iatrogenic BRT hemorrhage between January 2003 and December 2012 were reviewed retrospectively. Spring steel coils with gelatin sponge particles were used to embolize branches of the renal artery in 15 patients with injuries to the segmental or distal renal arteries; super-selective internal iliac artery branch embolization was used to occlude hemorrhage from the branch of the renal artery in two patients with pelvic fracture complicated with internal iliac artery branch laceration; and balloon catheter occlusion was used to embolize the branch of the renal artery in one patient with renal artery trunk laceration.
Embolization was achieved successfully in a one-stop procedure in all cases. The patient who received balloon catheter occlusion for renal artery trunk laceration was transferred immediately to surgery for emergency nephrectomy. Another patient died of intracranial trauma 1 day after surgery, although macroscopic hematuria disappeared at the time. Macroscopic hematuria disappeared within 1 day after surgery in the other 14 patients. Follow-up visits at times ranging from 6 months to 9 years after the procedure showed normal renal function without evidence of complications in all surviving patients.
Superselective transcatheter renal artery embolization is an effective minimally invasive therapy for the treatment of BRT hemorrhage.
探讨超选择性经导管肾动脉栓塞治疗非医源性钝性肾外伤（BRT）出血的疗效和转归。
回顾性分析 2003 年 1 月至 2012 年 12 月期间 16 例接受超选择性经导管肾动脉栓塞治疗非医源性 BRT 出血的患者。15 例节段性或远端肾动脉损伤患者采用弹簧钢圈联合明胶海绵颗粒栓塞肾动脉分支；2 例骨盆骨折合并髂内动脉分支撕裂患者采用超选择性髂内动脉分支栓塞；1 例肾动脉主干撕裂患者采用球囊导管闭塞肾动脉分支。
所有患者均一次性成功完成栓塞术。1 例接受肾动脉主干撕裂球囊导管闭塞的患者，因立即转外科行急诊肾切除术。另 1 例患者术后 1 天死于颅内创伤，尽管当时肉眼血尿已消失。14 例患者术后 1 天内肉眼血尿消失。术后 6 个月至 9 年的随访显示，所有存活患者的肾功能正常，无并发症证据。
超选择性经导管肾动脉栓塞术是治疗 BRT 出血的一种有效微创治疗方法。
