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Author Gupta, Nakul ♦ Patel, Anish ♦ Ensor, Joe ♦ Ahrar, Kamran ♦ Ahrar, Judy ♦ Tam, Alda ♦ Odisio, Bruno ♦ Huang, Stephen ♦ Murthy, Ravi ♦ Mahvash, Armeen ♦ Avritscher, Rony ♦ McRae, Stephen ♦ Sabir, Sharjeel ♦ Wallace, Michael ♦ Matin, Surena ♦ Gupta, Sanjay
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword RADIOLOGY AND NUCLEAR MEDICINE ♦ ARTERIES ♦ BIOMEDICAL RADIOGRAPHY ♦ CONTAINERS ♦ FISTULAE ♦ KIDNEYS ♦ MEDICAL RECORDS ♦ NEOPLASMS ♦ NEPHRECTOMY ♦ PAIN ♦ PANCREAS ♦ PATIENTS ♦ REVIEWS ♦ SOCIO-ECONOMIC FACTORS ♦ VASCULAR DISEASES
Abstract PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.
ISSN 01741551
Educational Use Research
Learning Resource Type Article
Publisher Date 2017-02-15
Publisher Place United States
Journal Cardiovascular and Interventional Radiology
Volume Number 40
Issue Number 2


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