Department of Diagnostic and Interventional Radiology, Osijek University Hospital Center. Osijek, Croatia.
Department of Radiology, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
Acta Clin Croat. 2023 Jul;62(Suppl2):153-157. doi: 10.20471/acc.2023.62.s2.23.
Higher turnaround of urologic patients in the tertiary clinical center can lead to more accompanying complications, ranging from 1% to 55% for various procedures, with the incidence of vascular injuries varying from 0.43% up to 9.5%. In patients with impaired renal function, it is imperative to prevent the loss of normal kidney function and potential hemodialysis. Being minimally invasive, endovascular procedures such as renal artery embolization (RAE) can treat major and life-threatening complications, but good and prompt communication between urologists and interventional radiologist is necessary for fast and effective treatment. Absolute contraindications for RAE are the presence of acute infection and previously known anaphylactic reaction to the iodine contrast media, while previous mild or moderate allergic reactions to iodine contrast media are not contraindications for RAE. Currently used embolic agents can be divided into temporary and permanent embolization agents. While the temporary embolization agent available is a gelatin sponge that could be used as complementary material or stand-alone, for permanent embolization interventional radiologists use microparticles, microspheres, liquid embolic agents, coils, and microcoils. RAE procedures are considered to be safe with a low incidence of complications, with non-target embolization being the most serious one. Postembolization syndrome is considered to be the most common adverse effect and it involves around 90% of patients. The overall results show that RAE is a safe, minimally invasive procedure that can effectively treat significant complications caused by other urologic procedures, with the reported success rates of 87%-100%.
泌尿科患者在三级临床中心的周转率较高可能导致更多伴随并发症,各种手术的发生率从 1%到 55%不等,血管损伤的发生率从 0.43%到 9.5%不等。对于肾功能受损的患者,必须防止正常肾功能丧失和潜在的血液透析。作为一种微创治疗方法,肾动脉栓塞术(RAE)等血管内治疗方法可以治疗严重危及生命的并发症,但泌尿科医生和介入放射科医生之间必须进行良好和及时的沟通,以便进行快速有效的治疗。RAE 的绝对禁忌证是存在急性感染和先前已知的碘对比剂过敏反应,而先前对碘对比剂的轻度或中度过敏反应不是 RAE 的禁忌证。目前使用的栓塞剂可分为临时和永久性栓塞剂。虽然可用的临时栓塞剂是明胶海绵,可以作为补充材料或独立使用,但介入放射科医生使用微球、微球、液体栓塞剂、线圈和微线圈进行永久性栓塞。RAE 手术被认为是安全的,并发症发生率低,非靶向栓塞是最严重的并发症。栓塞后综合征被认为是最常见的不良反应,约 90%的患者会出现这种情况。总体结果表明,RAE 是一种安全的微创治疗方法,可有效治疗其他泌尿科手术引起的严重并发症,报告的成功率为 87%-100%。