Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement

Super-selective renal artery embolization is an increasingly popular technique for the management of traumatic, low-grade renal trauma. When performed in distal arterial branches, this intervention enables tissue preservation and arrest of hemorrhage, but it may not be practical in cases of multifocal, high-grade renal injuries. In such cases, surgical nephrectomy remains the more common treatment modality to ensure hemodynamic control. We present the unique case of a patient who presented in hemorrhagic shock following a major trauma that resulted in a grade 5 renal injury treated with complete renal artery embolization using Gelfoam, resulting in hemodynamic stabilization. Interestingly, imaging 1 month after embolization revealed residual enhancement of the inferior pole of the kidney, suggesting reconstitution of flow and partial renal salvage. Ultimately, transcatheter “nephrectomy” with careful selection of a temporary embolic agent may serve as a safe and efficient alternative to surgical nephrectomy with the added possibility of preserving partial renal perfusion and function in the emergent setting.

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A case of renal artery embolization for Grade 5 renal injury, usually reserved for surgery

West African Journal of Radiology ◽

10.4103/wajr.wajr_32_17 ◽

2018 ◽

Vol 25 (1) ◽

pp. 75

Author(s):

AbeekuAfedzi Hammond

Keyword(s):

Renal Artery ◽

Renal Injury ◽

Artery Embolization ◽

Grade 5 ◽

Renal Artery Embolization

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Trisacryl Gelatin Microembolism and Metastases in the Lung after Renal Artery Embolization and Nephrectomy for Renal Cell Carcinoma

Case Reports in Urology ◽

10.1155/2015/916268 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Andres Borja Alvarez ◽

Jack P. Leventhal ◽

Cherise Cortese ◽

Barbara L. McComb ◽

David D. Thiel ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Renal Artery ◽

Cell Carcinoma ◽

Renal Cell ◽

Lower Lobe ◽

Embolic Agent ◽

Artery Embolization ◽

Gelatin Microspheres ◽

First Report ◽

Renal Artery Embolization

This is the first report, to our knowledge, of widespread, histologically confirmed trisacryl gelatin pulmonary microembolism after renal artery embolization (RAE). In addition, this is the first report of lung involvement by both metastatic renal cell carcinoma (RCC) and an embolic agent used for RAE. The patient was a 63-year-old woman who recently presented with both dyspnea on exertion and productive cough. Her past medical history included clear cell RCC, which was treated with preoperative trisacryl gelatin microsphere RAE and right nephrectomy 9 years earlier. Computed tomography of the chest showed multiple lung nodules, a mass-like density in the left lower lobe, and mediastinal and hilar lymphadenopathy. Wedge resections of the lung showed multiple foci of metastatic RCC and extensive involvement of the muscular pulmonary arteries by trisacryl gelatin microspheres.

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A New Liquid Embolic Agent(Embol) for Transcatheter Renal Artery Embolization: An Experimental Study in Rabbit

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2002.46.1.17 ◽

2002 ◽

Vol 46 (1) ◽

pp. 17

Author(s):

Gyoo Sik Jung ◽

Ji Ho Ko ◽

Hyun Chul Kim ◽

Sang Hee Lee ◽

Kyung Seung Oh ◽

...

Keyword(s):

Experimental Study ◽

Renal Artery ◽

Embolic Agent ◽

Artery Embolization ◽

Liquid Embolic ◽

Liquid Embolic Agent ◽

Renal Artery Embolization

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Safety of Renal Biopsy by Physicians with Short Nephrology Experience

Healthcare ◽

10.3390/healthcare9040474 ◽

2021 ◽

Vol 9 (4) ◽

pp. 474

Author(s):

Kenta Torigoe ◽

Kumiko Muta ◽

Kiyokazu Tsuji ◽

Ayuko Yamashita ◽

Shinichi Abe ◽

...

Keyword(s):

Renal Artery ◽

Renal Biopsy ◽

Renal Diseases ◽

Complication Rates ◽

Artery Embolization ◽

Clinical Nephrology ◽

Percutaneous Renal Biopsy ◽

Artery Embolism ◽

Renal Artery Embolization ◽

Biopsy Complications

Percutaneous renal biopsy is an essential tool for diagnosing various renal diseases; however, little is known about whether renal biopsy performed by physicians with short nephrology experience is safe in Japan. This study included 238 patients who underwent percutaneous renal biopsy between April 2017 and September 2020. We retrospectively analyzed the frequency of post-renal biopsy complications (hemoglobin decrease of ≥10%, hypotension, blood transfusion, renal artery embolization, nephrectomy and death) and compared their incidence among physicians with varied experience in nephrology. After renal biopsy, a hemoglobin decrease of ≥10%, hypotension and transfusion occurred in 13.1%, 3.8% and 0.8% of patients, respectively. There were no cases of post-biopsy renal artery embolism, nephrectomy, or death. The composite complication rate was 16.0%. The incidence of post-biopsy complications was similar between physicians with ≥3 years and <3 years of clinical nephrology experience (12.5% vs. 16.8%, p = 0.64). Furthermore, the post-biopsy composite complication rates were similar between physicians with ≥6 months and <6 months of clinical nephrology experience (16.3% vs. 15.6%, p > 0.99). Under attending nephrologist supervision, a physician with short clinical nephrology experience can safely perform renal biopsy.

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