Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126, Ancona, Italy.
Division of Radiology, Department of Radiological Sciences, University Hospital "Azienda Ospedaliero Universitaria Delle Marche", 60126, Ancona, Italy.
Emerg Radiol. 2023 Oct;30(5):597-606. doi: 10.1007/s10140-023-02159-0. Epub 2023 Jul 22.
Transarterial embolization of renal artery branches (RTE) is a minimally invasive procedure commonly performed in life-threatening renal bleeding of different etiologies. Despite the widespread use of RTE, no consensus guidelines are currently available. Our aim was to investigate clinical and technical efficacy and to identify potential predictors for clinical failure of this procedure.
All the RTE procedures performed in our Interventional Radiology unit in last 10 years were retrospectively collected and analyzed. All selected patients underwent both pre-procedural computed tomography angiography (CTA) and post-procedural CTA within 30 days. Clinical success was considered as primary endpoint. Demographic, laboratory, and diagnostic findings predictive of clinical failure of RTE were identified.
Over a total of 51 patients enrolled, 27 (53%) were females and 33 (64.7%) had a renal bleeding of iatrogenic origin. Technical and clinical success was 100% and 80.4%, respectively. Hematoma volumes > 258.5 cm measured at CTA, higher pre- and post-procedural serum creatinine (Scr) levels, an increase in Scr value > 0.135 mg/dl after the procedure, a worse post-procedural estimated glomerular filtration rate (eGFR), a post-procedural reduction of eGFR < 3.350 ml/min, and a post-procedural reduction of platelet count (PLT) > 46.50 × 10/mmc showed a significantly higher rate of clinical failure.
RTE is a safe and effective procedure in the management of acute renal bleeding of various origins. Hematoma volume, Scr, PLT, and eGFR values were found to be predictive factors of poor clinical outcome and should be closely monitored.
经动脉栓塞术（RTE）是一种治疗不同病因引起的危及生命的肾出血的微创方法。尽管 RTE 已广泛应用，但目前尚无共识指南。我们的目的是研究该手术的临床和技术疗效，并确定该手术临床失败的潜在预测因素。
回顾性收集并分析了我们介入放射科过去 10 年中进行的所有 RTE 手术。所有选定的患者均在术前和术后 30 天内进行了计算机断层血管造影（CTA）检查。临床成功被视为主要终点。确定了预测 RTE 临床失败的人口统计学、实验室和诊断结果。
共纳入 51 例患者，其中 27 例（53%）为女性，33 例（64.7%）肾出血为医源性。技术和临床成功率分别为 100%和 80.4%。CTA 测量的血肿体积＞258.5cm、术前和术后血清肌酐（Scr）水平较高、术后 Scr 值升高＞0.135mg/dl、术后估算肾小球滤过率（eGFR）降低、术后 eGFR 降低＜3.350ml/min 和血小板计数（PLT）降低＞46.50×10/mmc 均显示临床失败率显著增加。
RTE 是治疗各种来源急性肾出血的一种安全有效的方法。血肿体积、Scr、PLT 和 eGFR 值是预测不良临床结局的因素，应密切监测。
