Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Print this page Email this page Users Online: 173
ORIGINAL ARTICLE
Year : 2020  |  Volume : 13  |  Issue : 3  |  Page : 210-214

Renal artery embolization: A minimally invasive technique in the treatment of acute intractable iatrogenic hematuria – Experience at a tertiary care center


1 Military Hospital Cardiothoracic Centre, Affiliated to Armed Forces Medical College, Pune, Maharashtra, India
2 Department of Radiodiagnosis and Intervention Radiology, Army Hospital (R and R), New Delhi, India
3 Department of Radiodiagnosis and Intervention Radiology, Armed Forces Medical College, Pune, Maharashtra, India

Correspondence Address:
Virender Malik
Military Hospital Cardiothoracic Centre, Pune - 411 040, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_210_19

Rights and Permissions

Introduction: Hematuria following iatrogenic trauma or renal vascular malformations is less common but important causes warranting definite emergency procedure in cases not responding to conservative management. Endovascular embolization is accepted as an effective technique for the treatment of acute intractable hematuria. Considering the need of microcatheter for selective embolization, its use during the procedure increases the procedural cost significantly. The purpose of the present study is to assess the effectiveness and safety of selective renal artery embolization in patients with intractable hematuria using a 4-F glide catheter (GC). The microcatheter usage during our study was intended to be restricted to cases where the GC was not navigable to the optimal site for embolization. Materials and Methods: A retrospective analysis was done for 21 cases with acute intractable hematuria referred to our center between January 2015 and February 2019. Fifteen male and 6 female patients were included. Seventeen cases followed iatrogenic injury during a renal biopsy, 2 cases were due to renal neoplasm, and 1 each due to PCN and abdominal trauma. Embolization was carried out after selective catheterization of the feeding artery, with a 4-F GC using polyvinyl alcohol (PVA) particles in combination with pushable coils in all cases. Results: The source of bleeding was identified as arteriovenous fistula (AVF) in 14, AVF with pseudoaneurysm (PA) in 3, PA alone in 2, and abnormal tumor vascularity in 2 patients. In all but 2 cases, the hematuria stopped within 24 h after embolization. In the remaining 2 cases, hematuria stopped completely within 72 h. One patient developed minor puncture site bleed with no major procedural complications or recurrence on follow-up. Conclusion: Endovascular embolization is a highly effective minimally invasive technique for the treatment of acute intractable hematuria. Good results were achieved without using any microcatheter (hence cost-effective) with no clinically significant nontarget embolization.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed274    
    Printed20    
    Emailed0    
    PDF Downloaded50    
    Comments [Add]    

Recommend this journal