Renal artery embolisation immediately prior to emergency trauma nephrectomy

2020 ◽  
pp. 205141582092764
Author(s):  
Richard Simpson ◽  
Anup Mathew ◽  
Bachar Zelhof
Keyword(s):  
Renal Artery ◽  
Retroperitoneal Space ◽  
Operating Theatre ◽  
Standard Approach ◽  
Renal Trauma ◽  
Mesenteric Injury ◽  
Renal Pedicle ◽  
Arterial Haemorrhage

The aim of emergency nephrectomy in cases of blunt renal trauma is to control bleeding and so should not be delayed. We present a case of grade V blunt renal trauma where renal artery emoblisation (RAE) was used in the operating theatre immediately prior to trauma nephrectomy in order to control arterial haemorrhage. In this case, prior utilisation of RAE allowed the urologist to perform a standard approach to the renal pedicle by opening the retroperitoneal space. This is more routinely practiced and carries less risk of vascular mesenteric injury compared with the standard approach in trauma. Intra-operatively, there was minimal bleeding and the intra-vascular coils were easily ligated. Post operatively the patient avoids the sequelae of an ischaemic kidney associated with delayed interval nephrectomy.

Trauma to the urinary tract and other urological emergencies

2019 ◽  
pp. 515-554
Author(s):  
John Reynard ◽  
Simon F Brewster ◽  
Suzanne Biers ◽  
Naomi Laura Neal
Keyword(s):  
Urinary Tract ◽  
Renal Artery ◽  
Renal Trauma ◽  
Artery Embolization ◽  
Surgical Exploration ◽  
The Third ◽  
Renal Artery Embolization ◽  
Urological Emergencies

Management of urological trauma remains much as it was at the time of the third edition of this handbook, though selective renal artery embolization is increasingly used when compared with surgical exploration for renal trauma with persistent bleeding.

"REFLEX" ANURIA IN THE DOG

1956 ◽  
Vol 34 (2) ◽  
pp. 158-169 ◽  
Author(s):  
Sydney M. Friedman ◽  
Roland W. Radcliffe ◽  
J. E. H. Turpin ◽  
Constance L. Friedman
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Femoral Vein ◽  
Venous Catheter ◽  
Renal Vasoconstriction ◽  
Contralateral Kidney ◽  
Renal Pedicle ◽  
Ureteral Catheters ◽  
Surgical Manipulations ◽  
Reflex Anuria

The effects of various surgical manipulations on the function of the separate kidneys was studied in the dog. The application of a clamp to one renal artery produced vasoconstriction of varying severity in the contralateral kidney. The introduction of a venous catheter into the renal vein by passage upward from the femoral vein similarly caused renal vasoconstriction. The combination of manipulations involved in preparing the renal pedicle for later renal artery clamping with the passing of renal venous and ureteral catheters frequently produced oliguria or complete anuria. Since such nociceptive stimuli can cause renal vasoconstriction and, if sufficiently severe, antidiuresis, it is inferred that these mechanisms bear directly on the problem of traumatic anuria.

Blood supply and distribution of albumin and red cells in rabbit kidney

1962 ◽  
Vol 202 (4) ◽  
pp. 805-811 ◽  
Author(s):  
Maria Serratto ◽  
C. Larkin Flanagan ◽  
David P. Earle
Keyword(s):  
Renal Artery ◽  
Blood Supply ◽  
Collateral Circulation ◽  
Renal Cortex ◽  
Renal Parenchyma ◽  
Red Cells ◽  
Rabbit Kidney ◽  
Left Renal Artery ◽  
Renal Pedicle ◽  
Supply And Distribution

Intravenously administered I131 albumin (RISA) is more concentrated in medulla than in cortex of the normal rabbit kidney. In contrast, labeled erythrocytes are more concentrated in normal rabbit renal cortex than in medulla. Collateral circulation to rabbit renal parenchyma arises from capsular and ureteral arteries. The magnitudes of these two blood supplies are small and roughly equal. Both cortex and medulla receive blood from both groups of collaterals. When capsular vessels alone supply the kidney, renal weight and concentrations of RISA and labeled erythrocytes increase progressively with time up to 1 hr. This suggests a preponderance of arterial over venous and lymphatic collaterals after acute renal pedicle occlusion. RISA concentration of the contralateral medulla of the rabbit whose left renal artery and vein have been occluded increases rapidly and remains high for 1 hr as compared to control animals.

Renal Artery Avulsion from Blunt Kidney Trauma

2021 ◽  
pp. 1-3
Author(s):  
Pycha A
Keyword(s):  
Conservative Treatment ◽  
Renal Artery ◽  
Abdominal Trauma ◽  
Organ Preservation ◽  
Urogenital Tract ◽  
Renal Trauma ◽  
Selective Embolization ◽  
Surgical Interventions ◽  
Kidney Trauma ◽  
Radiological Procedures

The kidney is the most frequently injured organ in the urogenital tract with more than 5% of all trauma [1, 2] and 10% of all abdominal trauma [3]. Young men are most commonly affected [4]. The management of renal trauma has shown a trend towards conservative treatment in recent years, even for higher-grade injuries (grade IV and V) [5]. The increased availability and use of interventional radiological procedures for the selective embolization of injured vessels has led to a reduction in open surgical interventions and thus to increased organ preservation [3, 5-7]. Injuries to the kidney vessels, especially the renal artery, are very rare with less than 5% of all abdominal trauma [3].

scholarly journals Renal artery pseudoaneurysm after blunt renal trauma: report on three cases and review of the literature

2013 ◽  
Vol 131 (5) ◽  
pp. 356-362 ◽  
Author(s):  
Kleiton Gabriel Ribeiro Yamacake ◽  
Marcos Lucon ◽  
Antonio Marmo Lucon ◽  
Jose Luiz Borges Mesquita ◽  
Miguel Srougi
Keyword(s):  
Renal Artery ◽  
Wide Spectrum ◽  
Case Reports ◽  
Rare Complication ◽  
Renal Trauma ◽  
Angiographic Embolization ◽  
Review Of The Literature ◽  
Selective Embolization ◽  
Artery Pseudoaneurysm ◽  
Renal Artery Pseudoaneurysm

CONTEXT: Renal artery pseudoaneurysm is a rare complication after renal injury but should be suspected whenever there is recurrent hematuria after renal trauma. CASE REPORTS: We present three cases of pseudoaneurysm after blunt renal trauma and a review of the literature. All patients underwent renal angiography. Two cases were diagnosed during the initial hospital stay due to hematuria, or in the follow-up period during recovery. One patient was hemodynamically unstable. Two patients successfully underwent coil embolization in a single session. In the other case, selective embolization was attempted, but was unsuccessful because artery catheterization was impossible. Procedural and medical success and complications were retrospectively assessed from the patients' records. The clinical presentation, treatment options and clinical decisions are discussed. CONCLUSIONS: Renal artery pseudoaneurysm may develop acutely or even years after the initial injury. Signs and symptoms may have a wide spectrum of presentation. Selective angiographic embolization is an effective treatment that reduces the extent of parenchymal infarction.

scholarly journals Our own method of combined treatment of acute purulent pyelonephritis: first results

2017 ◽  
Vol 7 (3) ◽  
pp. 34-37
Author(s):  
Vladimir A Anan’ev ◽  
Aleksej V Antonov
Keyword(s):  
Renal Artery ◽  
High Efficiency ◽  
Combined Treatment ◽  
Retroperitoneal Space ◽  
Intraarterial Infusion ◽  
Results Of Treatment ◽  
First Results

The article describes the author’s method of retroperitoneoscopic decapsulation of the kidney with removal of purulent foci, sanitation and drainage of the retroperitoneal space with subsequent catheterization of the renal artery with continuous intraarterial infusion of alprostadil in combined treatment of patients with acute purulent pyelonephritis. The results of treatment of 13 patients showed high efficiency as described above. The possibility and expediency of using of described technique is shown. (For citation: Anan’ev VA, Antonov AV. Our own method of combined treatment of acute purulent pyelonephritis: first results. Urologicheskie vedomosti. 2017;7(3):34-37. doi: 10.17816/uroved7334-37).

"REFLEX" ANURIA IN THE DOG

1956 ◽  
Vol 34 (1) ◽  
pp. 158-169
Author(s):  
Sydney M. Friedman ◽  
Roland W. Radcliffe ◽  
J. E. H. Turpin ◽  
Constance L. Friedman
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Femoral Vein ◽  
Venous Catheter ◽  
Renal Vasoconstriction ◽  
Contralateral Kidney ◽  
Renal Pedicle ◽  
Ureteral Catheters ◽  
Surgical Manipulations ◽  
Reflex Anuria

The effects of various surgical manipulations on the function of the separate kidneys was studied in the dog. The application of a clamp to one renal artery produced vasoconstriction of varying severity in the contralateral kidney. The introduction of a venous catheter into the renal vein by passage upward from the femoral vein similarly caused renal vasoconstriction. The combination of manipulations involved in preparing the renal pedicle for later renal artery clamping with the passing of renal venous and ureteral catheters frequently produced oliguria or complete anuria. Since such nociceptive stimuli can cause renal vasoconstriction and, if sufficiently severe, antidiuresis, it is inferred that these mechanisms bear directly on the problem of traumatic anuria.

Sign in / Sign up

Export Citation Format

Share Document