Clinical outcome and safety of selective renal artery embolization using permanent occlusive agents for acute renal bleeding

• Published in: Egyptian Journal of Radiology and Nuclear Medicine Vol. 51; no. 1; pp. 205 - 10
• Main Authors: Alwarraky, Mohamed S., Abdallah, Mohamed M., Elgharbawy, Mohamed S.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 08.10.2020; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Biopsy; Catheters; Clinical outcomes; Coils; Contusions; Embolization; Glue; Hematuria; Imaging; Intubation; Medical imaging; Medicine; Medicine & Public Health; Nitriles; Nuclear Medicine; Patients; Permanent; Polymerization; Pseudoaneurysm; Radiology; Renal bleeding; Safety and security measures; Surgery; Veins & arteries; United States > US; Japan; Coils; Embolization; Hematuria; Permanent; Glue; Renal bleeding
• ISSN: 0378-603X; 2090-4762
• DOI: 10.1186/s43055-020-00328-6

Background To evaluate how far is selective renal artery embolization (RAE) using permanent agents effective in treating acute renal artery bleeding. We retrospectively reviewed the medical records of patients ( n = 45) with renal bleeding who were managed by selective RAE using coils, N-butyl-cyanoacrylate glue (NBCA glue), and polyvinyl alcohol (PVA). Data retrieved included the cause, number, and type of the bleeding lesions as well as the results of the embolization for 1 year after RAE. Clinical success was the primary outcome while re-bleeding and complications were the secondary outcomes. Results There were 55 bleeding lesions detected by angiography in the included 45 patients. Coils were used in 23/45 patients (51.1%), NBCA glue in 15/45 patients (33.3%), and PVA in 7 patients (15.6%). Bleeding could be controlled with embolization in a single session in 41/45 patients with primary clinical success 91.1%. Four patients needed re-embolization sessions to control bleeding and only one patient was controlled, giving secondary clinical success of 92.3%. Three patients failed to respond to embolization and nephrectomy was done. Iatrogenic dissection of the segmental branch was seen in one patient. Post embolization syndrome was seen in 14/45 patients (31.1%). Non-target embolization was seen in 2 patients: one during treatment with NBCA glue and the other with PVA. No other complications were recorded. No significant differences between clinical success among coil, NBCA glue, and PVA subgroups ( P > 0.05). Conclusion Selective RAE using permanent agents is effective in controlling renal bleeding and no significant difference among coil, NBCA glue, and PVA.