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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

67-year-old man with asymptomatic renal artery aneurysm that was incidentally discovered on CT scan of abdomen.A. Selective arteriogram demonstrating filling of saccular renal aneurysm arising from hilar branch.B. Control angiography after embolization of aneurysmal sac across neck with detachable fibered microcoils and using packing technique: there is near complete occlusion of aneurysm and preservation of main renal artery.
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Figure 7: 67-year-old man with asymptomatic renal artery aneurysm that was incidentally discovered on CT scan of abdomen.A. Selective arteriogram demonstrating filling of saccular renal aneurysm arising from hilar branch.B. Control angiography after embolization of aneurysmal sac across neck with detachable fibered microcoils and using packing technique: there is near complete occlusion of aneurysm and preservation of main renal artery.

Mentions: Many of these aneurysms require surgery, which is very effective. It is generally accepted that an asymptomatic saccular aneurysm of the renal artery of less than a 15 mm diameter should not be treated. Exceptions include women with normal genital function who wish to conceive, any aneurysm that engenders renal ischemia and arterial hypertension, any aneurysm associated with significant stenosis of the renal artery, any dissecting aneurysm, any aneurysm with distal embolization or any aneurysm that shows an increase in size on successive images. Embolization can be considered in frail patients with aneurysms that have a narrow neck or a favorable anatomical configuration (Fig. 7). In such cases the downstream bed and the arterial lumen must be preserved (30, 31). The aneurysm is generally occluded by inserting metallic coils into the sac. If the neck is wide, then a fenestrated endoprosthesis can be initially used to cover the aneurysm, after which the coils can be inserted via the windows in the prosthesis (32). The use of a recently developed small covered endoprostheses can sometimes simplify the procedure.


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)

67-year-old man with asymptomatic renal artery aneurysm that was incidentally discovered on CT scan of abdomen.A. Selective arteriogram demonstrating filling of saccular renal aneurysm arising from hilar branch.B. Control angiography after embolization of aneurysmal sac across neck with detachable fibered microcoils and using packing technique: there is near complete occlusion of aneurysm and preservation of main renal artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: 67-year-old man with asymptomatic renal artery aneurysm that was incidentally discovered on CT scan of abdomen.A. Selective arteriogram demonstrating filling of saccular renal aneurysm arising from hilar branch.B. Control angiography after embolization of aneurysmal sac across neck with detachable fibered microcoils and using packing technique: there is near complete occlusion of aneurysm and preservation of main renal artery.
Mentions: Many of these aneurysms require surgery, which is very effective. It is generally accepted that an asymptomatic saccular aneurysm of the renal artery of less than a 15 mm diameter should not be treated. Exceptions include women with normal genital function who wish to conceive, any aneurysm that engenders renal ischemia and arterial hypertension, any aneurysm associated with significant stenosis of the renal artery, any dissecting aneurysm, any aneurysm with distal embolization or any aneurysm that shows an increase in size on successive images. Embolization can be considered in frail patients with aneurysms that have a narrow neck or a favorable anatomical configuration (Fig. 7). In such cases the downstream bed and the arterial lumen must be preserved (30, 31). The aneurysm is generally occluded by inserting metallic coils into the sac. If the neck is wide, then a fenestrated endoprosthesis can be initially used to cover the aneurysm, after which the coils can be inserted via the windows in the prosthesis (32). The use of a recently developed small covered endoprostheses can sometimes simplify the procedure.

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