HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2233011216v1 223/3/723    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dinkel, H.-P. Articles by Triller, J. Search for Related Content PubMed PubMed Citation Articles by Dinkel, H.-P. Articles by Triller, J.

Blunt Renal Trauma: Minimally Invasive Management with Microcatheter Embolization—Experience in Nine Patients¹

¹ From the Departments of Diagnostic Radiology (H.P.D., J.T.) and Urology (H.D.), University of Bern, Inselspital, Freiburgstrasse 20, CH 3010 Bern, Switzerland. Received July 18, 2001; revision requested September 11; revision received October 24; accepted November 13. Address correspondence to H.P.D. (e-mail: hans-peter.dinkel@insel.ch).

PURPOSE: To evaluate superselective embolization therapy for the management of arterial damage in patients with severe renal trauma.

MATERIALS AND METHODS: Nine consecutive patients with renovascular injuries after blunt trauma underwent superselective embolization. Six patients had pseudoaneurysms or traumatic arteriovenous fistulas. Three patients had frank, uncontained extravasation (two shattered kidneys, one complete pedicle avulsion) and were treated immediately after admission. Two patients were hemodynamically unstable. All patients underwent embolization with 3-F coaxial microcatheters and polyvinyl alcohol particles (n = 2) or 0.018-inch platinum microcoils (n = 7). Procedural and medical success and complications (eg, postembolization syndrome, abscess, permanent serum creatinine elevation, hypertension) were retrospectively assessed from the patients’ records. Mean clinical follow-up was 11.9 months (range, 1–50 months).

RESULTS: In all cases bleeding was effectively controlled with superselective embolization in a single session. There was no procedure-related loss of renal tissue in eight cases; in one patient, a lower pole remnant of 20% of viable ipsilateral parenchyma was lost due to the procedure. In one patient, a coil migrated into a lumbar artery without causing clinical consequences. None of the patients developed abscess, hypertension, or procedure-related impairment of renal function.

CONCLUSION: Superselective embolization may be used for effective, minimally invasive control of active renovascular bleeding.

© RSNA, 2002

Index terms: Arteries, therapeutic embolization, 96.1264 • Kidney, injuries, 81.41, 81.48 • Kidney, interventional procedures, 81.1264

This article has been cited by other articles:

				T M Wah and J A Spencer CT of adult urinary tract trauma Imaging, August 1, 2005; 17(1): 53 - 68. [Abstract] [Full Text] [PDF]