SUPERSELECTIVE EMBOLIZATION OF THE RENAL ARTERIES AS A MONOTHERAPY OF KIDNEY TUMOR IN A PATIENT WITH HIGH ANESTHESIOLOGIC RISK

Introduction: Renal artery embolization is a minimally invasive X-ray endovascular operation that is used in the treatment of various urological diseases. This operation is of increasing interest due to its ability to occlude not only proximal, but also distal renal vessels with a low risk of complications. Recent developments in endovascular technology make embolization one of the effective and safe methods applicable to stop renal bleeding, preoperative preparation for surgical treatment of renal malignant tumors, and first-line treatment for angiomyolipomas. For a certain category of patients, renal artery embolization is practically no alternative method of treatment. This applies to comorbid patients with kidney tumors and aggravated somatic status, in whom the anesthetic risk makes open or laparoscopic surgical treatment impossible, and embolization can reduce symptoms, improve the quality of life of such patients and prolong the patient's life.Clinical case: we demonstrate the experience of X-ray surgical treatment of cT1aN0M0 left kidney cancer in an 80-year-old patient.Conclusion: Embolization of renal arteries in some cases can be an effective and safe alternative treatment for renal cell carcinoma in somatically burdened patients who cannot perform surgical treatment.

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Renal artery embolization in patients with locally advanced and advanced renal cancer, as the first stage of minimally invasive surgical treatment before radical nephrectomy

Health of Man ◽

10.30841/2307-5090.4(55).2015.104768 ◽

2015 ◽

Vol 0 (4(55)) ◽

pp. 114-115

Author(s):

М. І. Ухаль ◽

О. М. Семанів

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Renal Artery ◽

Radical Nephrectomy ◽

Locally Advanced ◽

Artery Embolization ◽

Advanced Renal Cancer ◽

Minimally Invasive Surgical ◽

Renal Artery Embolization ◽

Minimally Invasive Surgical Treatment

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Method of diagnosis and treatment of profusional bleeding from stenosing postbulbar ulcers of the duodenum

EUREKA Health Sciences ◽

10.21303/2504-5679.2021.001730 ◽

2021 ◽

pp. 37-43

Author(s):

Volodymyr Mamchych ◽

Sergiy Vereshchagin ◽

Volodymyr Maksymchuk ◽

Dmytro Maksymchuk

Keyword(s):

Duodenal Ulcer ◽

Surgical Treatment ◽

Clinical Protocols ◽

Artery Embolization ◽

X Ray ◽

Endovascular Interventions ◽

Superselective Embolization ◽

Near Future ◽

Damaged Vessel ◽

Angiography And Embolization

The aim. To evaluate the effectiveness of X-ray interventions in arosive bleeding in patients with complicated duodenal ulcer. Materials and methods. X-ray endovascular interventions were used in 8 patients who developed arosive bleeding as a complication of duodenal ulcer. All patients with signs of gastrointestinal bleeding were examined according to clinical protocols. Hemodynamically stable patients underwent X-ray endovascular interventions. Results and discussion. In the near future, bleeding stopped in all 8 (100 %, OR–0.04 [0.005–0.29], p=0.03) patients. On day 2, two patients who underwent embolization of their own hepatic artery had a recurrence of bleeding (0.56 [0.065–4.76], p=0.29). Repeated angiography and embolization attempts were ineffective, and both patients died. In patients who underwent gastroduodenal and pancreatouodenal artery embolization, bleeding did not resume. Thus, we obtained good results as 6 out of 8 patients recovered (75 %), despite the severity of their condition and a disappointing prognosis (OR–9.0 [1.0–46.7], p <0.05). Conclusions. Adherence to the tactics mentioned above in the treatment of bleeding in duodenal ulcer was highly effective, especially in superselective embolization with the detection of bleeding gel. If the presence of arosive bleeding is confirmed, emergency surgical treatment with suturing of the damaged vessel is shown in hemodynamically unstable patients, and endovascular intervention is possible in hemodynamically stable patients. Further studies are needed to determine the criteria for a high risk of arosive bleeding developing in patients with complicated duodenal ulcer as well as to prevent its occurrence through the use of X-ray endovascular interventions.

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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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Renal Artery Embolization for Neoplastic Conditions

Seminars in Interventional Radiology ◽

10.1055/s-0040-1715884 ◽

2020 ◽

Vol 37 (04) ◽

pp. 420-425

Author(s):

Alex Lionberg ◽

James Jeffries ◽

Thuong G. Van Ha

Keyword(s):

Renal Artery ◽

Artery Embolization ◽

Renal Artery Embolization

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Ex Vivo Repair of a Renal Artery Saccular Aneurysm in a Living-Nonrelated Donor and Subsequent Successful Kidney Transplantation

Vascular and Endovascular Surgery ◽

10.1177/1538574418770104 ◽

2018 ◽

Vol 52 (6) ◽

pp. 455-458

Author(s):

Rogerio A. Muñoz-Vigna ◽

Javier E. Anaya-Ayala ◽

Juan N. Ramirez-Robles ◽

Daniel Nuño-Diaz ◽

Sandra Olivares-Cruz

Keyword(s):

Kidney Transplantation ◽

Renal Artery ◽

Ex Vivo ◽

Incidental Finding ◽

Left Kidney ◽

Renal Arteries ◽

Saccular Aneurysm ◽

Preoperative Imaging ◽

The Right ◽

Stage Renal Disease

The use of kidney grafts with aneurysmal disease involving the renal arteries for transplantation is very uncommon and relatively controversial. We herein present the case of a 52-year-old woman who volunteered to become a living-nonrelated donor; during the preoperative imaging workup, a computed tomography angiography revealed a 1.5-cm saccular aneurysm in the left kidney, while the contralateral renal artery was normal. We decided to utilize the left kidney for a 25-year-old male patient with end-stage renal disease, and following the ex vivo repair using the recipient epigastric vessels and saphenous veins, we completed the transplantation in the right pelvic fossa. The postoperative period was uneventful, and at 8 months from the surgery, the graft remains functional. The surgical repair of renal artery aneurysms followed by immediate kidney transplantation is a safe technique and an effective replacement therapy for recipients. The incidental finding of isolated aneurysmal disease in renal arteries should not exclude graft potential availability for transplantation following repair.

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