Haochen Wang, Jian Wang, Li Song, Tianshi Lv, Xiaoqiang Tong, Yinghua Zou
Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China.
J Int Med Res. 2019 Apr;47(4):1649-1659. doi: 10.1177/0300060519828528. Epub 2019 Feb 14.
This study aimed to determine if superselective renal artery embolization is a safe and effective method of treating bleeding complications after percutaneous renal biopsy.
From January 2006 to December 2017, 43 patients (22 men and 21 women, mean age: 44.5 ± 14.0 years) underwent angiography for post-biopsy bleeding complications following percutaneous biopsy. Patients underwent angiography and superselective artery embolization. We recorded serum creatinine and hemoglobin values to assess the effect of embolization.
Successful embolization was achieved in all patients. There was a pseudoaneurysm in 10 cases, arteriovenous fistula in eight, contrast media extravasation in 16, arteriovenous fistula combined with contrast media extravasation in five, and pseudoaneurysm combined with arteriovenous fistula in four. The embolic substance was a microcoil only or combined with a gelatin sponge. The mean creatinine value was not different at 1 day and 1 week after embolization compared with before embolization. Mean hemoglobin values were significantly higher at 1 day and 1 week after embolization than before embolization.
Superselective renal artery embolization is a safe and effective treatment for post-biopsy bleeding complications after percutaneous renal biopsy. Lumbar or iliolumbar artery angiography is necessary if renal arteriography shows no signs of hemorrhage.
本研究旨在确定超选择性肾动脉栓塞术是否是治疗经皮肾活检后出血并发症的一种安全有效的方法。
2006年1月至2017年12月,43例患者(22例男性和21例女性,平均年龄:44.5±14.0岁)因经皮肾活检后出血并发症接受血管造影。患者接受了血管造影和超选择性动脉栓塞术。我们记录血清肌酐和血红蛋白值以评估栓塞效果。
所有患者均成功栓塞。10例存在假性动脉瘤,8例存在动静脉瘘,16例存在造影剂外渗,5例动静脉瘘合并造影剂外渗,4例假性动脉瘤合并动静脉瘘。栓塞物质仅为微线圈或与明胶海绵联合使用。栓塞后1天和1周时的平均肌酐值与栓塞前相比无差异。栓塞后1天和1周时的平均血红蛋白值明显高于栓塞前。
超选择性肾动脉栓塞术是治疗经皮肾活检后出血并发症的一种安全有效的方法。如果肾动脉造影未显示出血迹象,则需要进行腰动脉或髂腰动脉造影。