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Value of Angioembolization in the Treatment of Iatrogenic Renal Vascular Injury Assisted by 3-Dimensional Digital Subtraction Angiography

Xin Liao, Hao Xu, Fan Liu, Xuli Min, Yugen Li, Lin Yang, Yongjun Ren

Intervention Center of Fifth People’s Hospital of Nanchong City, Fifth People’s Hospital of Nanchong City, Nanchong, Sichuan, China (mainland)

Med Sci Monit 2020; 26:e927208

DOI: 10.12659/MSM.927208

Available online: 2020-08-27

Published: 2020-09-02

BACKGROUND: This study was conducted to investigate the reliability and efficacy of polyvinyl alcohol combined with coils in the embolization of iatrogenic renal vascular injury with the assistance of 3-dimensional digital subtraction angiography (3D-DSA).
MATERIAL AND METHODS: Twenty-six patients with minimally invasive renal bleeding who underwent transarterial embolization from January 2012 to January 2019 in our hospital were included in the study. We obtained demographic data from these patients, as well as information on clinical presentation, renal procedures used for treatment, and perioperative details. The changes in renal function tests, serum hemoglobin, serum hematocrit, and technetium Tc 99m dimercaptosuccinic acid (99mTc-DMSA) levels pre- and postembolization were compared. In addition, the embolic area and the technical and clinical success rates were analyzed. Finally, an angiographic manifestation of the renal artery, 3D-DSA, and the effect of embolization were analyzed retrospectively.
RESULTS: All patients achieved technical and clinical success after embolization (100%, 26/26). There were no significant differences between pre- and postoperative estimated glomerular filtration rate, serum parameters, and 99mTc-DMSA. The embolic area was 12%±10%. Patients did not exhibit severe complications during the follow-up period.
CONCLUSIONS: Proximal embolization technique assisted by 3D-DSA for renal iatrogenic hemorrhage and vascular lesions is both safe and efficacious, offering high rates for both clinical and technical success. It maximizes the protection of the kidney and reduces the rate of renal resection.

Keywords: Angiography, Digital Subtraction, Embolization, Therapeutic, Iatrogenic Disease, Nephrostomy, Percutaneous, Polyvinyl Alcohol