Negative renal angiography with subsequent denied angioembolization: findings in a series of 180 patients at a tertiary interventional uroradiology unit

Abstract Background Renal arterial embolization (RAE) is considered to be a safe and effective method for treating a variety of renal lesions and pathology. It is the optimal method not only to stop bleeding, but to preserve renal parenchyma and renal function. Patients who are scheduled to RAE who showed negative catheter angiography with the procedure subsequently denied have a special concern because they are subjected to unnecessary procedure with its complications and didn’t get its benefits. This circumstance is infrequently reported in the literature, and that compelled us to identify the predictors of negative renal angiography findings that would result in a failure to undertake RAE. Results The study included 180 patients (126 males; 70%) with a mean ± SD age of 44 ± 14 years. Iatrogenic causes were the most common indication for RAE (108 of 180; 60%), while spontaneous unknown reasons constituted (17 of 180 patients; 9%). Angiography showed various lesions in 148 patients: pseudoaneurysm (80 of 148; 54%), tumours (28 of 148; 19%), arteriovenous (AV) fistulas (22 of 148; 15%) and both pseudoaneurysm and AV fistulas (18 of 148; 12%). However, in the remaining 32 of 180 patients (18%) no lesions were identified on renal angiography and RAE procedures were not undertaken. On bivariate analysis, neither gender, side of the lesions, haematuria prior to RAE, or renal artery anatomy were predictors for negative angiography. However, the indication for RAE (spontaneous unknown reasons) of renal haemorrhage was the only predictor for negative angiography (9/17 (53%), P = 0.001). Conclusion Patients scheduled for RAE may show negative findings with no lesions on renal angiography. Among the different indications for RAE, patients with spontaneous (unknown) have the highest probability (53%) of being associated with negative renal angiography findings, however, those with renal tumours and post-traumatic causes have a low probability. In those patients with spontaneous (unknown), conservative management should be the initial treatment of choice in order to avoid unnecessary RAE and its associated complications.

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Post-traumatic growth and influencing factors among frontline nurses fighting against COVID-19

Occupational and Environmental Medicine ◽

10.1136/oemed-2020-106540 ◽

2020 ◽

pp. oemed-2020-106540

Author(s):

Pan pan Cui ◽

Pan pan Wang ◽

Kun Wang ◽

Zhiguang Ping ◽

Peng Wang ◽

...

Keyword(s):

Linear Regression ◽

Multiple Linear Regression ◽

Influencing Factors ◽

Psychological Intervention ◽

Linear Regression Analysis ◽

Bivariate Analysis ◽

Related Factors ◽

Self Confidence ◽

Post Traumatic Growth ◽

Post Traumatic

ObjectiveTo explore the level and influencing factors of frontline nurses’ post-traumatic growth (PTG) during COVID-19 epidemic.MethodsA cross-sectional survey was conducted in February 2020 in three hospitals in China. The Post-traumatic Growth Inventory (PTGI) was used to investigate the PTG of frontline nurses. Data on related factors, including demographic characteristics and subjective variables, were collected. The Event-Related Rumination Inventory was used to assess rumination. Pearson’s or Spearman’s correlation was calculated for bivariate analysis. Independent sample t-tests or one-way analysis of variance and multiple linear regression analysis were used to examine the related factors.ResultsA total of 179 frontline nurses were recruited, and 167 were included in the analyses. The mean PTG score was 70.53±17.26. The bivariate analyses showed that deliberate rumination was modestly positively correlated with PTG (r=0.557, p<0.01), while intrusive rumination had a modest negative correlation with PTG (r=−0.413, p<0.01). Multiple linear regression demonstrated that working years, self-confidence in frontline work, awareness of risk, psychological intervention or training during the epidemic and deliberate rumination were the main influencing factors of PTG among frontline nurses and accounted for 42.5% of the variance (F=31.626, p<0.001).ConclusionsThe PTG of frontline nurses was at a medium to high level and was influenced by working years, self-confidence in frontline work, awareness of risk, psychological intervention or training and deliberate rumination. It is necessary to strengthen psychological guidance and training for frontline nurses and promote their deliberate rumination on epidemic events to improve their PTG.

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Treatment of a urinoma and a post-traumatic pseudoaneurysm using selective arterial embolization

CardioVascular and Interventional Radiology ◽

10.1007/s002709900313 ◽

1998 ◽

Vol 21 (6) ◽

pp. 506-508 ◽

Cited By ~ 9

Author(s):

Isabel T. Pinto ◽

Paloma C. Chimeno

Keyword(s):

Arterial Embolization ◽

Selective Arterial Embolization ◽

Traumatic Pseudoaneurysm ◽

Post Traumatic

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Bleeding Pseudocyst of the Pancreatic Head. The role of Omentoplasty and Local Hemostasis

HPB Surgery ◽

10.1155/1994/23181 ◽

1994 ◽

Vol 8 (2) ◽

pp. 123-128 ◽

Cited By ~ 2

Author(s):

Francesco Stipa ◽

Adolfo Gavelli ◽

Claude Huguet

Keyword(s):

Surgical Treatment ◽

Mortality Rate ◽

Pancreatic Resection ◽

Pancreatic Head ◽

Postoperative Mortality ◽

Arterial Embolization ◽

Arterial Ligation ◽

Post Traumatic

Treatment of bleeding psedoaneurysms and pseudocysts of the pancreas is controversial. Surgical treatment with pancreatic resection or trancystic arterial ligation is not always satisfactory since postoperative mortality rate is high, especially for lesions located in the pancreatic head and rebleeding is not unusual. Two patients with bleeding pseudoaneurysms (one post traumatic, one spontaneous) and one with a hemorrhagic pseudocyst of the pancreatic head were treated surgically with arterial suture and omentoplasty. Bleeding was controlled in all, without any postoperative mortality or morbidity. No rebleeding occurred with a follow up of 33, 26 and 12 months. Trancystic ligation of bleeding vessels with omentoplasty may be a useful approach, which should be compared to arterial embolization in the future.

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Post-traumatic arterial priapism: Colour Doppler examination and superselective arterial embolization

Clinical Radiology ◽

10.1016/s0009-9260(98)80195-5 ◽

1998 ◽

Vol 53 (11) ◽

pp. 830-834 ◽

Cited By ~ 24

Author(s):

B.C. Kang ◽

D.Y. Lee ◽

J.Y. Byun ◽

S.Y. Baek ◽

S.W. Lee ◽

...

Keyword(s):

Arterial Embolization ◽

Colour Doppler ◽

Doppler Examination ◽

Post Traumatic

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Successful superselective arterial embolization for post-traumatic high-flow priapism

International Journal of Urology ◽

10.1111/j.1442-2042.2007.01574.x ◽

2007 ◽

Vol 14 (3) ◽

pp. 254-256 ◽

Cited By ~ 11

Author(s):

Tetsuya Takao ◽

Keigo Osuga ◽

Akira Tsujimura ◽

Kiyomi Matsumiya ◽

Norio Nonomura ◽

...

Keyword(s):

Arterial Embolization ◽

High Flow ◽

Post Traumatic

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Embolization of Spontaneous Intratumoral Hemorrhage with the Hemodynamic Characteristics of Arteriovenous Fistula in Renal Angiomyolipoma

Case Reports in Nephrology and Dialysis ◽

10.1159/000371844 ◽

2015 ◽

Vol 5 (1) ◽

pp. 54-59 ◽

Cited By ~ 2

Author(s):

Nao Kikuchi ◽

Ryohei Kuwatsuru ◽

Shinsuke Kyogoku ◽

Akihiko Shiraishi ◽

Shingo Okada ◽

...

Keyword(s):

Renal Vein ◽

Left Renal Vein ◽

Arterial Embolization ◽

Systemic Circulation ◽

Renal Angiomyolipoma ◽

Renal Angiography ◽

Av Fistula ◽

Intratumoral Hemorrhage ◽

First Choice ◽

Hemodynamic Characteristics

Aneurysms within renal angiomyolipomas (AML) may rupture into the tumor or pararenal space. Transcatheter arterial embolization is the first-choice treatment to control bleeding. Here, we describe the use of coil embolization in two cases of spontaneous intratumoral hemorrhage with the hemodynamic characteristics of renal arteriovenous (AV) fistula in renal AML. In case 1, renal angiography showed several intratumoral aneurysms, one of which had ruptured into the tumor, resulting in the formation of an intratumoral hematoma. Blood flow within the hematoma was rapid and the blood was immediately returned to the systemic circulation through the left renal vein. In case 2, renal angiography showed that the rupture of an intratumoral aneurysm of a tumor-feeding artery had resulted in formation of an intratumoral hematoma and direct renal vein communication. No extratumoral hemorrhage was observed in either case. The hemodynamics of both hematomas resembled those of a high-flow renal AV fistula. The ruptured aneurysms were embolized with detachable and pushable coils (case 1) or pushable coils only (case 2). To our knowledge, this is the first report of successful embolization of AV fistula-like intratumoral hemorrhage in renal AML.

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Treatment of Post-traumatic Urinoma by Means of Selective Arterial Embolization

Journal of Vascular and Interventional Radiology ◽

10.1016/s1051-0443(97)70544-x ◽

1997 ◽

Vol 8 (2) ◽

pp. 221-224 ◽

Cited By ~ 7

Author(s):

Kensaku Horikami ◽

Yohjiro Matsuoka ◽

Kenji Nagaoki ◽

Yuhei Amamoto ◽

Takeo Hori ◽

...

Keyword(s):

Arterial Embolization ◽

Selective Arterial Embolization ◽

Post Traumatic

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Endovascular Interventional Radiology of the Urogenital Tract

Medicina ◽

10.3390/medicina57030278 ◽

2021 ◽

Vol 57 (3) ◽

pp. 278

Author(s):

Fabio Pozzi Mucelli ◽

Roberta A. Pozzi Mucelli ◽

Cristina Marrocchio ◽

Saverio Tollot ◽

Maria A. Cova

Keyword(s):

Interventional Radiology ◽

Endovascular Procedures ◽

Hemorrhagic Cystitis ◽

Arterial Embolization ◽

Urogenital System ◽

Emergency Intervention ◽

Arteriovenous Fistulas ◽

Inflammatory Conditions ◽

Radiation Induced ◽

Post Traumatic

Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.

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