Presented by: Horacio V. Sanguinetti MD, PHD.
Hospital de clinicas Jose de San Martin.

Introduction

Selective renal embolization is a minimally invasive procedure historically used to treat various renal conditions, such as tumors and vascular lesions. At our hospital, a series of cases of selective renal embolization have been performed, with diverse etiologies. The aim of this study is to analyze the efficacy and safety of this treatment at our center.

Materials

Retrospective descriptive study analyzing the medical records of patients who underwent endovascular treatment for anemic hematuria, regardless of the cause, at José de San Martin Clinical Hospital from 2013 to 2023. Selective renal embolization was performed by inserting a catheter into the femoral artery, followed by a hydrophilic cobra catheter towards the affected renal artery. Once in the renal artery, an embolic solution was administered to block blood flow. We evaluated the cause of the renal injury, number of embolizations, computed tomography and angiographic findings, embolization materials used, number of transfused blood units, and postoperative complications of embolization.

Results

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A total of 7 patients were included, 5 females and 2 males, with a mean age of 58.7 years (42-72 years). The mechanism of injury was 14.2% renal artery aneurysms, 14.2% renal trauma, 28.5% percutaneous renal biopsy, and 42% were post-endourological procedures (URS and NLP). Renal mass preservation was achieved in 57.6% of patients, while 42.8% required emergency nephrectomy due to persistent hematuria with hemodynamic decompensation. Regarding the safety of the procedure, no major complications were observed post-embolization. The most common complications were fever (57.1%), lumbar region pain (42.8%), and renal collection (14.2%), all of which were satisfactorily resolved with conservative treatment. Computed tomography and angiography findings included contrast extravasation in one patient, pseudoaneurysms in three patients, perirenal hematoma in two patients, and renal aneurysm in one patient. The mean number of blood units transfused was 4.5 (range: 1-8 UPR).

Conclusion

Selective renal embolization is an effective and safe option as a rescue measure in patients with massive renal bleeding. The results of this retrospective study in our hospital suggest that this procedure can be successfully performed and provide a valuable alternative to open surgery or radical nephrectomy.

Funding

We do not have funds in the work.

Lead Authors

Mayra Ivette Caipe Bedoya, MD
Hospital de Clinicas Jose de San Martin.

Co-Authors

Eduardo Edilio Ventura Semidey, MD
Hsopital de Clinicas Jose de San Martin

Marcos Luis Nuñez, MD
Hospital de Clinicas Jose de San Martin

Juan Guillermo Ruiz, MD
Hospital de Clinicas Jose de San Martin

Norberto Bernardo, MD
Hospital de Clinicas Jose de San Martin.