Department of Radiology, Dankook University Hospital, Cheonan, Korea.
Department of Radiology and Research Institute of Radiology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
Int J Urol. 2019 Mar;26(3):406-412. doi: 10.1111/iju.13891. Epub 2018 Dec 21.
To present the radiological and clinical results of transcatheter arterial embolization in patients with active bleeding after percutaneous renal procedures.
A total of 79 consecutive patients who underwent angiography for percutaneous renal procedure-related bleeding were included in the present retrospective analysis. Patient characteristics, angiographic management and clinical outcomes were analyzed.
On angiography, bleeding foci were observed in 81.0% of the patients (64/79), all of whom underwent transcatheter arterial embolization. Among the 15 patients (19.0%) with negative angiographic findings, empirical transcatheter arterial embolization was carried out in six patients (40.0%). The technical success rate in 64 patients with positive angiographic findings was 100%, and the clinical success rate in 70 patients who underwent transcatheter arterial embolization was 85.7% (60/70). A total of 14.3% (10/70) of patients with clinical failure underwent repeat transcatheter arterial embolization and all achieved clinical recovery. There were no major complications. There was no statistical difference in estimated glomerular filtration rate values before the percutaneous renal procedure and those measured 7 days after transcatheter arterial embolization (43.4 ± 24.4 to 44.6 ± 25.1 mL/min/1.73 m ; P = 0.189). Clinical failure was not associated with age, sex, type of renal procedures, bleeding tendency, presence of active bleeding on angiography, latency time and embolic agents used (P > 0.05).
Transcatheter arterial embolization is a safe and effective method of treating percutaneous renal procedure-related bleeding without renal function deterioration.
介绍经导管动脉栓塞术治疗经皮肾操作后活动性出血的放射学和临床结果。
本回顾性分析共纳入 79 例因经皮肾操作相关出血而行血管造影的连续患者。分析患者特征、血管造影处理和临床结果。
血管造影显示 81.0%(64/79)的患者存在出血灶,所有患者均接受了经导管动脉栓塞术。在 15 例(19.0%)血管造影阴性的患者中,有 6 例(40.0%)进行了经验性经导管动脉栓塞术。64 例血管造影阳性患者的技术成功率为 100%,70 例行经导管动脉栓塞术的患者的临床成功率为 85.7%(60/70)。14.3%(10/70)的临床失败患者行重复经导管动脉栓塞术,均获得临床康复。无重大并发症。经皮肾操作前和经导管动脉栓塞术后 7 天的估算肾小球滤过率值无统计学差异(43.4±24.4 比 44.6±25.1 mL/min/1.73 m 2;P=0.189)。临床失败与年龄、性别、肾操作类型、出血倾向、血管造影上是否存在活动性出血、潜伏期和使用的栓塞剂无关(P>0.05)。
经导管动脉栓塞术治疗经皮肾操作相关出血是一种安全有效的方法,不会导致肾功能恶化。