Embolisation for Major Iatrogenic Renal Vascular Injuries

Objective: To evaluate the efficacy of renal angiography and transarterial embolisation in the management of major iatrogenic renal vascular injuries. Patients and Methods: Records of 9 patients with major renal vascular complications (pseudoaneurysm or arteriovenous fistula) after percutaneous renal procedures were reviewed. They were investigated with digital subtraction angiography followed by transarterial embolisation using various embolic agents. Indications for embolisation were gross or persistent haematuria that resulted in unstable haemodynamic status or that required blood transfusion. Postembolisation angiography was performed for all patients. Results: All the pseudoaneurysms and arteriovenous fistulas were successfully embolised in 1 session without any procedure-related complications. In all patients, clinical symptoms disappeared and haemodynamic status returned to normal after embolisation. Conclusion: Transarterial embolisation is an effective and safe technique in the management of major iatrogenic renal vascular injuries, and should be the first treatment option in acute clinical situations. In most cases, technical success can be achieved with minimal renal parenchymal tissue loss.