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Transcatheter arterial embolization in patients with kidney diseases: an overview of the technical aspects and clinical indications.

Loffroy R, Rao P, Kwak BK, Ota S, De Lin M, Liapi E, Geschwind JF - Korean J Radiol (2010)

Bottom Line: Therapeutic embolization is defined as the voluntary occlusion of one or several vessels, and this is achieved by inserting material into the lumen to obtain transient or permanent thrombosis in the downstream vascular bed.There are a number of indications for this approach in urological practice, in particular for the patients with parenchymatous or vascular kidney disease.The complications, side effects and main precautions associated with this approach are also described.

View Article: PubMed Central - PubMed

Affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Cardiovascular and Interventional Radiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. romaric.loffroy@yahoo.fr

ABSTRACT
Therapeutic embolization is defined as the voluntary occlusion of one or several vessels, and this is achieved by inserting material into the lumen to obtain transient or permanent thrombosis in the downstream vascular bed. There are a number of indications for this approach in urological practice, in particular for the patients with parenchymatous or vascular kidney disease. In this review, we present the different embolization techniques and the principally employed occluding agents, and then we present the principal clinical indications and we discuss other pathologies that may benefit from this non-invasive therapy. The complications, side effects and main precautions associated with this approach are also described.

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Related in: MedlinePlus

Emergency embolization for arterial injury after blunt renal trauma in 51-year-old woman.A. Extravasation of contrast medium (pseudoaneurysm-like lesion) from lower distal-pole branch at selective angiography indicates continuous bleeding (arrow).B. Selective embolization of feeding artery using detachable microcoils.C. Control angiogram shows complete and selective occlusion of bleeding branch, with no active bleeding.
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Figure 4: Emergency embolization for arterial injury after blunt renal trauma in 51-year-old woman.A. Extravasation of contrast medium (pseudoaneurysm-like lesion) from lower distal-pole branch at selective angiography indicates continuous bleeding (arrow).B. Selective embolization of feeding artery using detachable microcoils.C. Control angiogram shows complete and selective occlusion of bleeding branch, with no active bleeding.

Mentions: In the hours that follow the trauma, it may not be possible to stop the bleeding, which may result in a state of shock (9). Emergency arteriography will very often reveal the injured vessels (23). It is quite simple to occlude the artery that feeds the damaged region using inert particles, resorbable material, glue or microcoils according to the morphology of the lesions (Fig. 4). Hemostasis can generally be achieved (24). The few reported incidences of recurrent bleeding occurred when resorbable material was used. In these cases, the bleeding was stopped by repeat embolization. The renal infarction that can result from such interventions is often invisible or minor, as can be noted on surveillance examinations. This technique is only slightly aggressive and it preserves the renal parenchyma.


Transcatheter arterial embolization in patients with kidney diseases: an overview of the technical aspects and clinical indications.

Loffroy R, Rao P, Kwak BK, Ota S, De Lin M, Liapi E, Geschwind JF - Korean J Radiol (2010)

Emergency embolization for arterial injury after blunt renal trauma in 51-year-old woman.A. Extravasation of contrast medium (pseudoaneurysm-like lesion) from lower distal-pole branch at selective angiography indicates continuous bleeding (arrow).B. Selective embolization of feeding artery using detachable microcoils.C. Control angiogram shows complete and selective occlusion of bleeding branch, with no active bleeding.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864852&req=5

Figure 4: Emergency embolization for arterial injury after blunt renal trauma in 51-year-old woman.A. Extravasation of contrast medium (pseudoaneurysm-like lesion) from lower distal-pole branch at selective angiography indicates continuous bleeding (arrow).B. Selective embolization of feeding artery using detachable microcoils.C. Control angiogram shows complete and selective occlusion of bleeding branch, with no active bleeding.
Mentions: In the hours that follow the trauma, it may not be possible to stop the bleeding, which may result in a state of shock (9). Emergency arteriography will very often reveal the injured vessels (23). It is quite simple to occlude the artery that feeds the damaged region using inert particles, resorbable material, glue or microcoils according to the morphology of the lesions (Fig. 4). Hemostasis can generally be achieved (24). The few reported incidences of recurrent bleeding occurred when resorbable material was used. In these cases, the bleeding was stopped by repeat embolization. The renal infarction that can result from such interventions is often invisible or minor, as can be noted on surveillance examinations. This technique is only slightly aggressive and it preserves the renal parenchyma.

Bottom Line: Therapeutic embolization is defined as the voluntary occlusion of one or several vessels, and this is achieved by inserting material into the lumen to obtain transient or permanent thrombosis in the downstream vascular bed.There are a number of indications for this approach in urological practice, in particular for the patients with parenchymatous or vascular kidney disease.The complications, side effects and main precautions associated with this approach are also described.

View Article: PubMed Central - PubMed

Affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Cardiovascular and Interventional Radiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. romaric.loffroy@yahoo.fr

ABSTRACT
Therapeutic embolization is defined as the voluntary occlusion of one or several vessels, and this is achieved by inserting material into the lumen to obtain transient or permanent thrombosis in the downstream vascular bed. There are a number of indications for this approach in urological practice, in particular for the patients with parenchymatous or vascular kidney disease. In this review, we present the different embolization techniques and the principally employed occluding agents, and then we present the principal clinical indications and we discuss other pathologies that may benefit from this non-invasive therapy. The complications, side effects and main precautions associated with this approach are also described.

Show MeSH
Related in: MedlinePlus