[Embolization of iatrogenic renal vascular lesions with coaxial catheters and microcoils].

INTRODUCTION

We report our experience with the superselective embolization of iatrogenic vascular injuries. We used new coaxial catheters and new microcoils to assess their technical features and efficacy.

MATERIALS AND METHODS

Diagnostic angiography by catheterization of the main renal artery was performed in 7 patients with suspected renal vascular injury to detect injury presence and site. After super-selective catheterization of the feeding arteries with a coaxial catheter (Tracker 18), we performed embolization with platinum microcoils inserted using a coil pusher. The procedure efficacy was assessed at angiography and by comparing serum hemoglobin and hematocrit levels before and after embolization; posttreatment renal function was also studied.

RESULTS

Selective embolization permitted complete occlusion of the arteries feeding the vascular injury in all patients, preserving as much parenchyma as possible. Hemoglobin and hematocrit levels were improved or unchanged after the maneuver (average hemoglobin level before embolization: 9.01 mg/dl versus 9.95 mg/dl after embolization; average hematocrit level before embolization: 27.3% versus 30.06% after embolization). We had no difficulty during microcoil insertion and the coaxial catheter was always stable.

CONCLUSION

Superselective embolization of iatrogenic vascular injuries is an effective and definitive treatment. We recommend it in the patients with renal bleeding due to iatrogenic vascular injury after percutaneous diagnostic or therapeutic procedures.