Farg Hashim Mohamed, Elawdy Mohamed, Soliman Karim Ali, Badawy Mohamed Ali, Elsorougy Ali, Mohsen Tarek, El-Diasty Tarek, Abdelhamid Abdalla
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Curr Urol. 2023 Sep;17(3):213-218. doi: 10.1097/CU9.0000000000000161. Epub 2022 Jul 11.
The lack of overall experience and reporting on angiographic findings in previously published studies of renal arterial embolization (RAE) compelled us to report our overall experience on a series of patients.
A retrospective study was performed analyzing data of patients enrolled for RAE between 2010 and 2019. History, physical examination, and laboratory data were reviewed for all patients. Abdominal ultrasound was the initial imaging study, and all patients underwent subsequent computed tomography or magnetic resonance imaging. The outcome of RAE was determined based on radiographic and clinical findings.
Data from 202 patients were analyzed, with a mean age of 45 ± 15 years, and 71.3% of patients were male. Iatrogenic injury was the most common indication for RAE (54%), followed by renal tumors, trauma, and spontaneous, in 27.7%, 10.4%, and 8.4% of patients, respectively. Renal angiography revealing pseudoaneurysm alone or with other pathology in the lower pole of the kidney was the most common finding (40.6%), whereas no lesions were identified on angiography in 32 patients (15.8%), after which RAE was subsequently aborted. Renal arterial embolization was successful in 158 of 170 patients (92.9%) after 1 or more trials (maximum of 4). Microcoil alone or with other embolic materials was the most commonly used material for embolization (85%).
Iatrogenic injury was the most common indication for RAE. Pseudoaneurysm alone or with other lesions was the most common lesion on renal angiography; however, angiography showed a negative result in 16% of patients, even those with symptoms. When lesions are present on angiography, the overall success of repeated trials of RAE reached 92.9%.
在先前发表的肾动脉栓塞术（RAE）研究中，缺乏对血管造影结果的全面经验和报告，这促使我们报告我们对一系列患者的总体经验。
进行了一项回顾性研究，分析2010年至2019年期间接受RAE治疗的患者数据。对所有患者的病史、体格检查和实验室数据进行了回顾。腹部超声是初始影像学检查，所有患者随后均接受了计算机断层扫描或磁共振成像检查。根据影像学和临床检查结果确定RAE的结果。
分析了202例患者的数据，平均年龄为45±15岁，71.3%的患者为男性。医源性损伤是RAE最常见的适应证（54%），其次是肾肿瘤、创伤和自发性病变，分别占患者的27.7%、10.4%和8.4%。肾血管造影显示单纯假性动脉瘤或伴有肾下极其他病变是最常见的发现（40.6%），而32例患者（15.8%）血管造影未发现病变，随后中止了RAE。170例患者中的158例（92.9%）在1次或更多次尝试（最多4次）后肾动脉栓塞成功。单纯微线圈或与其他栓塞材料联合是最常用的栓塞材料（85%）。
医源性损伤是RAE最常见的适应证。单纯假性动脉瘤或伴有其他病变是肾血管造影最常见的病变；然而，即使有症状的患者，血管造影在16%的患者中显示为阴性结果。当血管造影发现病变时，重复进行RAE尝试的总体成功率达到92.9%。
