Evaluated The Therapeutic Effect Of Super-Selective Renal Arterial Embolization And Complications Of Iatrogenic Renal Hemorrhage

Objective:To investigate the hemostatic efficacy by super-selective renal artery embolization of iatrogenic renal hemorrhage, summarized embolization method and analyzes embolic complications and related processing.Methods:Retrospective of 38 cases of iatrogenic renal hemorrhage patient by super-selective renal artery embolization clinical data in the Second Affiliated Hospital of Kunming Medical University from July 2013 to March 2015, Analysis the reason and clinical manifestations of iatrogenic renal hemorrhage and indications, contraindications employed by super-selective renal artery embolization (SRAE), summarize the methods of embolism, selectivities of materials, hemostasis effect, manifestations and treatment of embolism syndrome.the Changesof renal function postoperative super-selective arterial embolization (SRAE) and blood pressure changes were analyzed.Results:Renal artery angiography revealed the injury site is located on the pole of the renal artery in 3 cases,12 cases of middle kidney pole, lower pole renal artery 15 cases, on two cases of kidney arteries,6 cases no injury site, simultaneously damaged. Contrast performance type 21 cases of renal pseudoaneurysm,1 case was revealed renal arteriovenous fistula, renal arteriovenous fistula merger pseudoaneurysm on 9 cases, one case of signs of contrast extravasation, angiography in 6 cases no obvious abnormalities.32 cases underwent embolization,28 patients using a simple coil embolization,3 cases of patients with coil embolization+gelatin sponge particles, one case in patients with suspected bleeding super-selective renal angiography of using a simple gelatin sponge embolization agents.6 cases no obvious abnormalities used thrombin infusion.32 cases in 29 cases of successful embolization disposable, one-time success rate of 90.6%.Where stopped bleeding and gross hematuria disappeard after embolization fistula 1 to 7 days,; 3 patients the issue of blood again in 1 to 3 days after embolization, carries out 2nd embolism, bleeding stopped; 1 patient death of multiple organ failure underwent embolization of the first three days; 6 patients routine thrombin infusion therapy, clinical follow-up after treatment of postoperative bleeding stop in 5-14 days.32 cases underwent embolization,12 cases symptom of pain in ipsilateral lumbar, no nausea, vomiting,10 patients with varying degrees of fever, body temperature at 37 ℃-38 ℃, after symptomatic treatment the symptoms subside. After review of creatinine, urea nitrogen suggesting that renal function were normal.postoperative radiographic follow-up of 1 to 12 months. CT, KUB and IVP showed no significant deformation of the renal pelvis, renal atrophy and embolic agents shifting. Follow-up blood pressure in one week to 12 months, no significant fluctuations in blood pressure. Renin, angiotensin Ⅱ (All), aldosterone (ALD) no significant change before and after embolization, with no correlation between blood and pressure.Conclusion:Super-selective renal artery embolization minimally invasive, effective and to the greatest extent retained renal function, choosing different embolic agents based on angiographic results, with less trauma, with advantages of less odds of postoperative renal function decline and renal vascular hypertension. Is a safe treatment for patients with iatrogenic renal hemorrhage preferred.