Grange Rémi, Magand Nicolas, Lutz Noémie, Lanoiselee Julien, Leroy Stéphanie, Boutet Claire, Grange Sylvain
Department of Radiology, University Hospital of Saint-Etienne, Avenue Albert Raimond, Saint-Priest-en-Jarez, 42270, France.
Department of Anesthesia, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France.
CVIR Endovasc. 2024 Dec 18;7(1):88. doi: 10.1186/s42155-024-00505-y.
Studies on emergency transarterial embolization (TAE) of renal arterial injuries are rare. The aim of this retrospective study was to evaluate clinical outcomes after emergency transarterial renal embolization.
Between January 1st, 2013 and January 1st, 2024, all consecutive patients treated for renal arterial injuries by TAE in emergency settings were retrospectively reviewed. Demographic, biological and angiographic data were recorded. The inclusion criteria were all patients ≥ 18-years-old treated by emergency TAE for renal vascular injury. Clinical success was defined as the resolution of bleeding signs without the need for repeat TAE, surgery, death related to massive blood loss during this period, without functional impairment (> 50% of parenchyma volume or onset of chronic kidney disease) following TAE.
During the inclusion period, 79 procedures were performed. The median age was 60[39-73] years old. On preoperative CT, ≥ 1 pseudoaneurysm was detected in 36(45.6%) patients, and active bleeding in 47(65.8%) patients. The preoperative median haemoglobin rate was 8.9[7.6-11] g/dl, and 37(46.8%) patients required red blood cell transfusions. The main aetiologies of arterial injury were blunt trauma (n = 19) and renal biopsy (n = 17). No severe adverse events were reported. Clinical success was reported in 74(93.7%) of the procedures. Three (3.8%) repeat embolizations were required, and were clinically successful. During the median follow-up of 7[1.5-35.5] months, 9(11.4%) patients died, of which 5(6.3%) occurred within 30 days.
The present study reports high clinical success, low complications and low rebleeding rates of emergency renal TAE.
关于肾动脉损伤的急诊经动脉栓塞术（TAE）的研究很少。这项回顾性研究的目的是评估急诊经动脉肾栓塞术后的临床结果。
回顾性分析2013年1月1日至2024年1月1日期间在急诊情况下接受TAE治疗肾动脉损伤的所有连续患者。记录人口统计学、生物学和血管造影数据。纳入标准为所有年龄≥18岁、因肾血管损伤接受急诊TAE治疗的患者。临床成功定义为出血征象消失，无需重复TAE、手术，在此期间无因大量失血导致的死亡，TAE后无功能损害（实质体积>50%或未发生慢性肾脏病）。
在纳入期间，共进行了79例手术。中位年龄为60[39 - 73]岁。术前CT检查发现，36例（45.6%）患者有≥1个假性动脉瘤，47例（65.8%）患者有活动性出血。术前中位血红蛋白率为8.9[7.6 - 11]g/dl，37例（46.8%）患者需要输注红细胞。动脉损伤的主要病因是钝性创伤（n = 19）和肾活检（n = 17）。未报告严重不良事件。74例（93.7%）手术取得临床成功。需要进行3例（3.8%）重复栓塞，且临床成功。在中位随访7[1.5 - 35.5]个月期间，9例（11.4%）患者死亡，其中5例（6.3%）在30天内死亡。
本研究报告了急诊肾TAE的高临床成功率、低并发症率和低再出血率。
