Multislice CT-Angiography in Percutaneous Postinterventional Hematuria and Kidney Bleeding: Influence of Diagnostic Outcome on Therapeutic Patient Management. Preliminary Results

Sadick, Maliha; Röhrl, Boris; Schnülle, Peter; Düber, Christoph; Diehl, Steffen J.

doi:10.1016/j.arcmed.2006.07.008

Cited by 10 publications

(7 citation statements)

References 28 publications

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“…50 Angioembolization may be appropriate in centers where experienced interventional radiologists are immediately available. Direct communication between the clinician and angiographer is critical.…”

Section: Guideline Statementsmentioning

confidence: 99%

Urotrauma: AUA Guideline

et al. 2014

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Purpose The authors of this guideline reviewed the urologic trauma literature to guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries. Methods A systematic review of the literature using the MEDLINE® and EMBASE databases (search dates 1/1/90-9/19/12) was conducted to identify peer-reviewed publications relevant to urotrauma. The review yielded an evidence base of 372 studies after application of inclusion/exclusion criteria. These publications were used to inform the statements presented in the guideline as Standards, Recommendations or Options. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high), B (moderate) or C (low). In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions.

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Section: Guideline Statementsmentioning

confidence: 99%

Urotrauma: AUA Guideline

et al. 2014

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“…However, there are only few reports on the ability of CTA to detect the source of renal hemorrhage in the literature. Sadick et al (10) found that CTA findings were 100% concordant with transcatheter therapeutic angiography in 7 patients with acute renal hemorrhage. Sommer et al (11) reported that arterial renal hemorrhage was identified by CTA in 42 of 43 patients (98%).…”

Section: Discussionmentioning

confidence: 98%

“…This may be important in the reproducibility of the results of our study. Third, the study group had a broader range of different diagnoses, including iatrogenic injuries, vascular malformations and angiomyolipoma, and was more heterogeneous than that of Sadick et al (10).…”

Section: Discussionmentioning

confidence: 99%

Clinical application of computed tomographic angiography in patients with renal arterial hemorrhage: Diagnostic accuracy and subsequent therapeutic outcome

Mao

Zhong

Lin

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to determine the accuracy of multi-section computed tomographic angiography (CTA) for the diagnosis of renal arterial h=emorrhage in comparison with digital subtraction angiography (DSA) and the effect of diagnostic outcome on therapeutic patient management. A retrospective analysis was conducted of the records of all patients undergoing DSA for acute renal hemorrhage between August 2005 and June 2014. A total of 74 patients were identified in whom CTA was performed prior to the DSA. DSA detected a renal arterial lesion in 68 cases and no bleeding was demonstrated in 6 cases. CTA correctly identified the bleeding site in 59 of the 68 DSA-positive cases. There were 14 patients with negative CTA results that underwent DSA after 2-10 days because of persistent hematuria, and 9 of them were found to have positive DSA results. The sensitivity, specificity, positive predictive value and negative predictive value of CTA for the detection of arterial lesions in the context of acute renal hemorrhage were 0.868, 0.833, 0.983 and 0.357, respectively. All patients with bleeding sites identified by DSA underwent superselective embolization in a single session. Five patients underwent a secondly embolization for recurrent hemorrhage. These results indicate that CTA is an accurate technique for the detection of major arterial hemorrhage and supports its use in the initial examination of these patients.

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“…We used CT-angiography for fast diagnosis in the case of delayed hemorrhage, which has been proven to be reliable and valid in detecting RPA aneurysms and other potential causes [ 15 , 27 ]. A ruptured RPA is the most common reason for delayed bleeding after PN.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the localization of the RPA can be easily identified in the CT-angiography. Together with the imaging of the arterial supply of the kidney, this facilitates a more targeted arterial embolization, eventually sparing time and radiation doses [ 27 ]. Furthermore, it might help to reduce contrast agent doses and hence impairment of renal function, which is important especially after partial nephrectomy.…”

Section: Discussionmentioning

confidence: 99%

Open Partial Nephrectomy for High-Risk Renal Masses Is Associated with Renal Pseudoaneurysms: Assessment of a Severe Procedure-Related Complication

Kriegmair

Mandel

Rathmann

et al. 2015

BioMed Research International

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Objectives. A symptomatic renal pseudoaneurysm (RPA) is a severe complication after open partial nephrectomy (OPN). The aim of our study was to assess incidence and risk factors for RPA formation. Furthermore, we present our management strategy. Patients and Methods. Clinical records of consecutive patients undergoing OPN were assessed for surgical outcome and postoperative complications. Renal masses were risk stratified for tumor complexity according to the PADUA score. Uni- and multivariate analysis for symptomatic RPAs were performed using the t-tests and logistic regression. Results. We identified 233 patients treated with OPN. Symptomatic RPAs were observed in 13 (5.6%) patients, on average 14 (4–42) days after surgery. Uni- and multivariate analysis identified tumor complexity to be an independent predictor for symptomatic RPAs (p = 0.004). There was a significant correlation between RPAs and transfusion and the duration of stay (p < 0.001 and p = 0.021). Symptomatic RPAs were diagnosed with CT scans and successfully treated with arterial embolization. Discussion. Symptomatic RPAs are not uncommon after OPN for high-risk renal masses. A high nephrometry score is a predictor for this severe complication and may enable a risk-stratified followup. RPAs can successfully be located by CT angiography, which enables targeted angiographic treatment.

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Multislice CT-Angiography in Percutaneous Postinterventional Hematuria and Kidney Bleeding: Influence of Diagnostic Outcome on Therapeutic Patient Management. Preliminary Results

Cited by 10 publications

References 28 publications

Urotrauma: AUA Guideline

Urotrauma: AUA Guideline

Clinical application of computed tomographic angiography in patients with renal arterial hemorrhage: Diagnostic accuracy and subsequent therapeutic outcome

Open Partial Nephrectomy for High-Risk Renal Masses Is Associated with Renal Pseudoaneurysms: Assessment of a Severe Procedure-Related Complication

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