肾动脉栓塞术在治疗医源性肾出血中的作用。

Role Of Renal Artery Embolization In Treatment Of Iatrogenic Renal Bleeding.

机构信息

Department of Radiology, Ain Shams University,Cairo,Egypt.

Department of Radiology, Kafrelsheikh University,Egypt.

出版信息

J Pak Med Assoc. 2023 Apr;73(Suppl 4)(4):S305-S309. doi: 10.47391/JPMA.EGY-S4-59.

DOI:10.47391/JPMA.EGY-S4-59

PMID:37482877

Abstract

OBJECTIVES

To review institutional experience about the effectiveness and safety of percutaneous trans-arterial renal artery embolization in the treatment of iatrogenic renal bleeding.

METHOD

The prospective study was conducted from December 2019 to December 2021 at Ain Shams University Hospital and Kafrelsheikh University Hospital, Egypt, and comprised patients of either gender who underwent renal artery embolization for iatrogenic arterial renal bleeding caused by percutaneous nephrolithotomy, renal biopsy and percutaneous nephrostomy. Diagnostic renal angiography was done to detect pseudoaneurysm and arteriovenous fistula. Embolization was done with either micro-coils or glue. Success of the procedure was defined astotal occlusion of the bleeding artery proved by post-embolization angiogram.

RESULTS

Of the 15 patients, 9(60%) were males and 6(40%) were females. The overall mean age was 35+/-14 years. Percutaneous nephrolithotomy was the main cause 8(53.3%), followed by renal biopsy 5(33.3%) and percutaneous nephrostomy 2(13.2%). There were 9(50%) cases of pseudoaneurysm and 6(40%) of arteriovenousfistula. Embolization was done with micro-coils in 5(33.3%) cases and with glue in 10(66.6%). The technical success rate was 15(100%). No major complicationsrequiring intensive care orsurgical intervention were encountered, and there was no significant differences in estimated glomerular infiltration rate or renal function after renal artery embolization (p>0.05).

CONCLUSIONS

Percutaneous endovascular renal artery embolization was found to be a safe and effective technique in the management of iatrogenic renal arterial injury.

摘要

目的

回顾经皮经动脉肾动脉栓塞治疗医源性肾出血的有效性和安全性的机构经验。

方法

这项前瞻性研究于 2019 年 12 月至 2021 年 12 月在埃及的艾因夏姆斯大学医院和卡夫雷谢赫大学医院进行，纳入了因经皮肾镜碎石术、肾活检和经皮肾造瘘术导致医源性动脉性肾出血而接受肾动脉栓塞的男女患者。诊断性肾血管造影用于检测假性动脉瘤和动静脉瘘。栓塞采用微线圈或胶。将出血动脉完全闭塞定义为栓塞后血管造影证实的成功。

结果

15 例患者中，9 例（60%）为男性，6 例（40%）为女性。总体平均年龄为 35+/-14 岁。经皮肾镜碎石术是主要原因 8 例（53.3%），其次是肾活检 5 例（33.3%）和经皮肾造瘘术 2 例（13.2%）。有 9 例（50%）为假性动脉瘤，6 例（40%）为动静脉瘘。栓塞采用微线圈 5 例（33.3%），采用胶 10 例（66.6%）。技术成功率为 15 例（100%）。未发生需要重症监护或手术干预的主要并发症，肾动脉栓塞后肾小球滤过率或肾功能无明显差异（p>0.05）。