Tzortzis G, Kolomodi D, Stathopoulou S, Kostakis A, Michail S, Pappas P, Revenas K
Department of Radiology, Laikon General Hospital of Athens, Greece.
Int Angiol. 1998 Mar;17(1):58-61.
Angiography and selective renal artery embolisation were performed in two patients with post-traumatic iatrogenic kidney lesions and intractable haematuria. One patient presented after a nephrolithotomy with rupture of a segmental branch of the renal artery well demonstrated on selective angiography which showed intraparenchymal extravasion of contrast medium. The other presented after a renal biopsy with severe haematuria. Angiography performed 10 days later demonstrated an arteriovenous fistula at the site of the puncture. Hyperselective embolisation achieved immediate control of the haematuria in both patients, with maximal preservation of the renal parenchyma and maintenance of good renal function. At follow-up 12 months later, there had been no recurrence of the haematuria. These results suggest that transcatheter embolisation should be considered the method of first choice in renal trauma accompanied by intractable haematuria before any surgery is attempted.
对两名患有创伤后医源性肾损伤和顽固性血尿的患者进行了血管造影和选择性肾动脉栓塞术。一名患者在肾切开取石术后出现肾动脉节段分支破裂，选择性血管造影清晰显示，造影剂在肾实质内外渗。另一名患者在肾活检后出现严重血尿。10天后进行的血管造影显示穿刺部位存在动静脉瘘。超选择性栓塞术立即控制了两名患者的血尿，最大程度地保留了肾实质并维持了良好的肾功能。在12个月后的随访中，血尿未复发。这些结果表明，在尝试任何手术之前，经导管栓塞术应被视为伴有顽固性血尿的肾创伤的首选方法。
