Embolization of iatrogenic vascular injuries of renal transplants: immediate and follow-up results.

PURPOSE

To evaluate the outcome in seven patients in whom iatrogenic vascular complications were treated with catheter embolization.

METHODS

Angiography showed an arteriovenous fistula in six of the seven patients, a pseudoaneurysm in three patients, and an arteriocaliceal fistula in three patients. Embolization was performed with GAW coils or microcoils in all cases. In three patients enbucrilate, polyvinyl alcohol, or absorbable gelatin powder was administered as an adjunct to the coils.

RESULTS

Angiographic success with total occlusion of the vascular injury was achieved in five of the seven patients and clinical success was achieved in four of seven cases. In two cases, nephrectomy after embolization was necessary because of renal artery occlusion or acute hemorrhage at the renal artery anastomosis, respectively. Infarction of 30%-50% of the renal parenchyma was seen in two cases.

CONCLUSION

Angiographically successful embolization is not necessarily associated with clinical success. The complication rate is high.