Embolization of iatrogenic vascular injuries of renal transplants : Immediate and follow-up results

• Published in: Cardiovascular and interventional radiology 1998-03, Vol.21 (2), p.129-134
• Main Authors: DORFFNER, R, THURNHER, S, PROKESCH, R, BANKIER, A, TURETSCHEK, K, SCHMIDT, A, LAMMER, J
• Format: Article
• Language: English
• Subjects: Adult; Aneurysm, False - diagnostic imaging; Aneurysm, False - etiology; Aneurysm, False - therapy; Angiography, Digital Subtraction; ARTERIES; Arteriovenous Fistula - diagnostic imaging; Arteriovenous Fistula - etiology; Arteriovenous Fistula - therapy; Biological and medical sciences; BIOMEDICAL RADIOGRAPHY; Biopsy, Needle - adverse effects; Diseases of the cardiovascular system; Embolization, Therapeutic; Female; Fistula - diagnostic imaging; Fistula - etiology; Fistula - therapy; GELATIN; HEMORRHAGE; Humans; INJURIES; Kidney - pathology; Kidney Diseases - diagnostic imaging; Kidney Diseases - etiology; Kidney Diseases - therapy; Kidney Transplantation; KIDNEYS; Male; Medical sciences; Middle Aged; NEPHRECTOMY; PATIENTS; PVA; Radiography, Interventional; RADIOLOGY AND NUCLEAR MEDICINE; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Renal Artery - diagnostic imaging; Renal Artery - injuries; Renal Veins - diagnostic imaging; Renal Veins - injuries; TRANSPLANTS; Tropical medicine; Urinary Fistula - diagnostic imaging; Urinary Fistula - etiology; Urinary Fistula - therapy; Vascular Diseases - diagnostic imaging; Vascular Diseases - etiology; Vascular Diseases - therapy
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s002709900228

To evaluate the outcome in seven patients in whom iatrogenic vascular complications were treated with catheter embolization. Angiography showed an arteriovenous fistula in six of the seven patients, a pseudoaneurysm in three patients, and an arteriocaliceal fistula in three patients. Embolization was performed with GAW coils or microcoils in all cases. In three patients enbucrilate, polyvinyl alcohol, or absorbable gelatin powder was administered as an adjunct to the coils. Angiographic success with total occlusion of the vascular injury was achieved in five of the seven patients and clinical success was achieved in four of seven cases. In two cases, nephrectomy after embolization was necessary because of renal artery occlusion or acute hemorrhage at the renal artery anastomosis, respectively. Infarction of 30%-50% of the renal parenchyma was seen in two cases. Angiographically successful embolization is not necessarily associated with clinical success. The complication rate is high.