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Transcatheter injection of absolute ethanol into the renal artery is an effective method of producing renal ablation. There has been no evidence of inadvertent damage to vessels or tissues remote from the target organ. The "postembolization syndrome" of pain, nausea, vomiting, and fever is minimal when compared with other methods of renal artery occlusion. Multiple mechanisms of action of intraarterial ethanol are proposed, including perivascular tissue toxicity, sludging of erythrocytes in small arteries, small artery spasm, and endothelial damage. Experience with this technique in six patients has resulted in specific recommendations regarding the amount and method of injection of ethanol. Angiographic criteria indicating adequate renal ablation are described.

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