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  • Title: Treatment of renal-vascular injury by transcatheter embolization: immediate and long-term effects on renal function.
    Author: Poulakis V, Ferakis N, Becht E, Deliveliotis C, Duex M.
    Journal: J Endourol; 2006 Jun; 20(6):405-9. PubMed ID: 16808653.
    Abstract:
    PURPOSE: To evaluate the impact of superselective embolization for treatment of renal-vascular injuries on renal function. PATIENTS AND METHODS: Between 1995 and 2004, four male patients and one female patient with a mean age of 45.4 years underwent embolization to control bleeding from renal-vascular injuries resulting from iatrogenic interventions (N = 4) or blunt abdominal trauma (N = 1). Angiography depicted a pseudoaneurysm in all patients, together with an arteriovenous fistula in one. Superselective embolization was achieved with 0.035- or 0.018-inch coils combined with a mixture of Histoacryl and Lipiodol in one patient. RESULTS: Bleeding was controlled in all patients and did not recur. No complications occurred after the procedure. Hematuria ceased within 3 days. The serum creatinine concentration returned to pre-injury values within 10 days. Embolization caused an immediate parenchymal ischemic area of 0 to 20% (mean 9%). The contrast-enhanced CT scan 6 months after the procedure revealed a parenchymal perfusion deficit of 0 to 10% (mean 5%). CONCLUSIONS: Superselective embolization resulted in permanent cessation of bleeding. Renal function was preserved in all the patients, and serum creatinine concentrations returned to the pre-injury values. Transcatheter embolization should be considered the treatment of choice in the management of renal-vascular injuries.
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