Eisenberger F, Marx F J, Schmiedt E
Urologe A. 1977 Jan;16(1):1-5.
Transfemoral cannulation of renal vessels with the Seldinger technique has been used as well as routine angiography in the following urologic indications. 1. Hypothermic in situ perfusion of the kidney in difficult surgical procedures on the renal parenchyma, e.g., multiple stones, stag-horn calculi, benign and malignant tumors in solitary, residual or functionally residual kidneys. The advantages of this method are sufficient time for surgery, no contamination of blood and therefore excellent view by means of complete ischemia and good long-term results of the renal function. 2. Embolization of inoperable renal tumors to reduce tumor growth and control bleeding. The material used for embolization was a modified preparation of homogenized autologous muscle tissue. 3. Occlusion of the renal artery prior to tumor nephrectomy by a flow-guided balloon catheter in order to reduce the difficulty of the surgical produce, e.g., in massive carcinomatous infiltration of the hilus vessels. 4. Retrograde phlebography of the left internal spermatic vein in recurrent or persistent varicocele and in infertility with only insignificant or doubtful varicocele. The advantage compared with orthograde phlebography via plexus pampiniformis is the direct evidence that the venous reflux causes the varicocele. When the technique has been mastered transfemoral cannulation of the renal vessels can be used in routinely in the clinic Critical consideration of the indications, however, is necessary.
采用Seldinger技术经股动脉插管至肾血管,并在以下泌尿外科适应症中进行常规血管造影。1. 在肾脏实质的困难手术中,如多发性结石、鹿角形结石、孤立肾、残留肾或功能残留肾中的良性和恶性肿瘤,对肾脏进行低温原位灌注。该方法的优点是手术时间充足,无血液污染,因此通过完全缺血可获得极佳视野,且肾功能长期效果良好。2. 对无法手术切除的肾肿瘤进行栓塞,以减少肿瘤生长并控制出血。用于栓塞的材料是经改良的自体肌肉组织匀浆制剂。3. 在肿瘤肾切除术之前,通过血流导向球囊导管闭塞肾动脉,以降低手术难度,例如在肾门血管大量癌浸润的情况下。4. 对复发性或持续性精索静脉曲张以及精索静脉曲张不明显或可疑的不育症患者,进行左侧精索内静脉逆行静脉造影。与经蔓状静脉丛进行顺行静脉造影相比,其优点是能直接证明静脉反流导致精索静脉曲张。当掌握该技术后,经股动脉插管至肾血管可在临床上常规使用。然而,必须对适应症进行严格考量。