Trans-Catheter Interventions in the Management of Renal Vascular Injuries
Keywords:
Trans-Catheter Interventions, Management, Renal Vascular, HematuriaAbstract
Background: Iatrogenic renovascular injuries have risen due to the growing prevalence of interventional procedures, including renal artery angioplasty, stenting, and percutaneous techniques. The aim of this work was to evaluate the role of trans-catheter interventions in the management of renal vascular injuries.
Methods: This prospective interventional work had been conducted on 46 individuals, aged from 19 to 65 years old, diagnosed with renal vascular injuries by computed tomography (32 cases) or ultrasonography (35cases), symptomatic patients who present with flank pain, hypertension, hematuria, and acute hemorrhage as life-threatening retroperitoneal hemorrhage. All patients were subjected to catheter angiography and embolization.
Results: Comparing the number of cases scheduled for procedure and outcome of management, three cases show persistent hematuria post catheterization, indicating proper control with significant p value (0.001). Only six cases presented by impaired renal functions postembolization, which were normalized /reduced to perinormal values within short period post procedure with satisfactory follow up. Follow up of patients using different imaging modalities, to assess renal function and morphology, among 6 cases underwent renal scan (renogram), Perfusion abnormalities were seldom recorded. The degree of Scar tissue was assessed according to the embolized region of the kidney and selectivity of procedure. In our studied cases, due to super selective embolization, mild scar tissue was noticed in 12 cases, 9 of them lower pole segmental branch of renal artery was embolized.
Conclusions: Endovascular management is an effective minimally invasive and safe procedure in the management of renal vascular injuries with preservation of renal functions and low minor and major complication
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