Affiliations: Department of Interventional Radiology, The First
Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong,
China | Wake Forest Institute of Regenerative Medicine, Wake
Forest University, Winston Salem, NC, USA | Department of Urology, The First Affiliated Hospital
of Sun Yat-Sen University, Guangzhou, Guangdong, China
Note: [] aCorresponding authors: Wenbo Guo, Department of Interventional
Radiology, The First Affiliated Hospital of Sun Yat-Sen University. NO.58,
ZhongShan Road 2, Guangzhou 510080, Guangdong, China. E-mail:
patrickguo2008@163.com; Yuanyuan Zhang, Wake Forest Institute for Regenerative
Medicine, Wake Forest School of Medicine, Medical Center Boulevard,
Winston-Salem, NC 27157, USA. Tel.: +1 336 713 1189; Fax: +1 336 713 7290;
E-mail: yzhang@wakehealth.edu
Abstract: The goal of this study is to evaluate the feasibility and efficacy
of percutaneous transarterial embolization for the treatment of serious renal
hemorrhage after renal biopsy. Nine patients with renal hemorrhage had frank
pain and gross hematuria as main symptoms after renal biopsy. Intrarenal
arterial injuries and perinephric hematoma were confirmed by angiography in all
cases. The arterial injuries led to two types of renal hemorrhage, Type I:
severe renal injure or intrarenal renal artery rupture (n=5), with contrast medium spilling out of the artery and spreading into renal
pelvis or kidney capsule in angiography; Type II, pseudo aneurysm or potential
risk of intrarenal artery injure (n=4), where contrast
medium that spilled out of intraartery was retained in the parenchyma as little
spots less than 5 mm in diameter in angiography. Transcatheter superselective
intrarenal artery embolization was performed with coils or microcoils (Type I
intrarenal artery injure) and polyvinyl alcohol particles (Type II injure). The
intrarenal arterial injuries were occluded successfully in all patients. Light
or mild back or abdominal pain in the side of the embolized kidney was found in
three patients following embolization procedures and disappeared 3 days later.
Serum creatinine and perinephric hematoma were stable, and gross hematuresis
stopped immediately (n=4) or 3–5 days
(n=3) after embolization. In conclusions, transcatheter
superselective intrarenal artery embolization as a minimally invasive therapy
is safe and effective for treatment of serious renal hemorrhage following
percutaneous renal biopsy.
