Lee Hyoung Nam, Yang Seung Boo, Goo Dong Erk, Kim Yong Jae, Lee Woong Hee, Hyun Dongho, Heo Nam Hun
Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan-si, KR.
Department of Radiology, Soonchunhyang University College of Medicine, Gumi Hospital, Gumi, KR.
J Belg Soc Radiol. 2020 Nov 6;104(1):59. doi: 10.5334/jbsr.2223.
To evaluate the effect of superselective renal artery embolization in terms of renal function and blood pressure, to compare the results between groups with different embolization extents, and to analyze risk factors of entire study population for postprocedural acute kidney injury (AKI).
The inclusion criteria were patients who underwent renal artery embolization from January 2009 to December 2019, with available serum creatinine and blood pressure data. The exclusion criteria were non-selective embolization of main renal artery, AKI before embolotherapy, and follow-up of less than one month. According to the extent of embolization, the patients were divided into two groups: Group A (1 segment) and Group B (2-4 segments).
A total of 48 patients were enrolled. There was a significant difference between pre- and postprocedural estimated glomerular filtration rate ( = 0.030). There were no significant difference between pre- and postprocedural blood pressure. The incidence of postprocedural AKI in group B was significantly higher than that in group A ( = 0.044). There was no significant difference in the incidence of the worsening of hypertension between the two groups. Chronic kidney disease and high embolization grade were predictive for postprocedural AKI ( = 0.012, 0.021).
Superselective embolization appears to be a safe procedure, but meticulous attention for AKI is required for patients who underwent embolization of more than one segmental artery. An attempt to minimize the extent of devascularization should be pursued to avoid postprocedural complications.
评估超选择性肾动脉栓塞术对肾功能和血压的影响,比较不同栓塞范围组之间的结果,并分析整个研究人群术后急性肾损伤(AKI)的危险因素。
纳入标准为2009年1月至2019年12月接受肾动脉栓塞术且有可用血清肌酐和血压数据的患者。排除标准为主肾动脉非选择性栓塞、栓塞治疗前存在AKI以及随访时间少于1个月。根据栓塞范围,将患者分为两组:A组(1个节段)和B组(2 - 4个节段)。
共纳入48例患者。术前和术后估计肾小球滤过率有显著差异( = 0.030)。术前和术后血压无显著差异。B组术后AKI的发生率显著高于A组( = 0.044)。两组高血压恶化的发生率无显著差异。慢性肾脏病和高栓塞分级是术后AKI的预测因素( = 0.012,0.021)。
超选择性栓塞术似乎是一种安全的手术,但对于接受超过一个节段动脉栓塞的患者,需要密切关注AKI。应尽量减少血管去神经化的程度,以避免术后并发症。