Percutaneous injection of acrylic glue into renal allograft pseudoaneurysm for control of intractable post-biopsy hematuria

A, Lal; Singhal, Manphool; Ramachandran, Raja; Rathi, Manish; Jha, Vivekanand; Khandelwal, Niranjan

doi:10.4103/0971-4065.127909

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…Just one patient required endovascular embolization due to recurrent severe hematuria after 24 hours. Lal et al reported percutaneous injection of acrylic glue and Lipiodol mixture into renal allograft PA in a case of intractable hematuria after biopsy.…”

Section: Discussionmentioning

confidence: 99%

Successful ultrasound‐guided percutaneous embolization of renal pseudoaneurysm by autologous blood clot: Preliminary report of a new method

Mehrjardi

Bagheri

Darabi

2017

J of Clinical Ultrasound

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We report the case of a 25-year-old female with renal arteriovenous fistula and pseudoaneurysm (PA) formation following renal core-needle biopsy, treated successfully by ultrasound-guided percutaneous embolization with autologous blood clot injection. After inserting a 15-gauge needle within the PA sac, 10 ml of blood was retrieved from the sac, and then reinjected into the PA as well as in the needle tract after the obtained blood completely clotted. The procedure was completed by manual compression of the flank. Follow-up sonographic examinations revealed no complication, and the PA size reduced gradually over time due to fibrotic shrinkage. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:592-596, 2017.

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Section: Discussionmentioning

confidence: 99%

Successful ultrasound‐guided percutaneous embolization of renal pseudoaneurysm by autologous blood clot: Preliminary report of a new method

Mehrjardi

Bagheri

Darabi

2017

J of Clinical Ultrasound

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“…Ultrasound-guided percutaneous injection of embolic agents into the pseudoaneurysm is done in patients who are hemodynamically stable and with unfavorable vascular anatomy or contrast allergy. [6][7][8] Studies have shown success rates of > 90% with angioembolization. 9 However, sufficient large study data are not available on the success rates of percutaneous embolization.…”

Section: Introductionmentioning

confidence: 99%

Interventional Radiology Management of Renal Pseudoaneurysms: Experience at a Tertiary Care Hospital

Gorsi

Soundararajan

Jugpal

et al. 2020

Journal of Clinical Interventional Radiology ISVIR

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Objectives Renal pseudoaneurysms are multifactorial in origin, and angioembolization remains the mainstay of treatment. Few case reports have also described percutaneous embolization using glue or thrombin. Our study aimed to evaluate the predictors of active bleed by analyzing their etiology, morphology, imaging features, and treatment adopted. To the best of our knowledge, this is the largest such study done in India. Methods This was a retrospective study of patients treated for renal pseudoaneurysms between 2014 and 2019. We reviewed their clinical data, treatment modalities used, and clinical outcomes. We also assessed computed tomography angiography (CTA) and conventional angiography images. Results A total of 79 patients (54 males and 25 females) were included in the study. The mean age was 39.5 years (range 15–83 years). The most common cause was renal biopsy, followed by surgery. Of these, three patients (3.9%) had more than one lesion and 57% of pseudoaneurysms were seen in lower polar arteries. Active contrast extravasation was seen in 15.2% (n = 12) of the patients and 21.5% (n = 17) showed lobulations in CT and digital substraction angiography. The mean size of the pseudoaneurysms was 1.17 cm (SD 0.7); 22.8% of pseudoaneurysms were wide necked. The embolization was approached by endovascular (89.9%), percutaneous (10.1%), or both (1.3%) routes. Embolization was performed using microcoils (78.5%), gel foam (12.7%), N-butyl cyanoacrylate glue (8.9%), polyvinyl alcohol (8.9%), and thrombin (5.1%) either as a single agent or in combination. The technical success was achieved in all cases after the first procedure. Pseudoaneurysms with a wide neck (p = 0.03) and lobulations (p = 0.002) were associated with active contrast extravasation. Episodes of rebleeding were seen at a younger age (p-value = 0.02). Conclusion Minimally invasive methods remain the cornerstone in the management of renal pseudoaneurysms with high success rates. The morphology of pseudoaneurysms can help predict the risk of active bleeding and decide the type of intervention. Direct percutaneous injection into the aneurysm sac is an alternate technique and should be considered when an endovascular approach is challenging.

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Acute Cellular Rejection

Menon

Cravedi

Salem

2017

Kidney Transplantation, Bioengineering and Regeneration

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Percutaneous injection of acrylic glue into renal allograft pseudoaneurysm for control of intractable post-biopsy hematuria

Cited by 4 publications

References 5 publications

Successful ultrasound‐guided percutaneous embolization of renal pseudoaneurysm by autologous blood clot: Preliminary report of a new method

Successful ultrasound‐guided percutaneous embolization of renal pseudoaneurysm by autologous blood clot: Preliminary report of a new method

Interventional Radiology Management of Renal Pseudoaneurysms: Experience at a Tertiary Care Hospital

Acute Cellular Rejection

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