Percutaneous renal ablation in patients with end-stage renal disease: alternative to surgical nephrectomy.

Abstract

Percutaneous transcatheter ablation was performed on 18 kidneys in ten patients with end-stage renal disease (ESRD), who were either on hemodialysis or had undergone renal transplantation, for the following indications: nephrotic syndrome with massive protein loss (seven patients, 13 kidneys), poorly controlled posttransplantation hypertension in the absence of transplant renal artery stenosis (two patients, three kidneys), and diabetic nephropathy with persistent urine leak from ureterocutaneous fistulas following pelvic irradiation (one patient, two kidneys). Desired clinical results were achieved in all cases. Percutaneous renal ablation is an effective alternative to surgery in patients with ESRD who require nephrectomy.

Perkutane Totalembolisation der Niere - eine Übersicht

“…Ist das Ziel eine dauerhafte Tumorausschaltung, so ist ein kapillarer Verschluss vorzuziehen, etwa durch konzentrierten Alkohol oder Ethibloc [11,18]. Handelt es sich lediglich um eine präopera-tive Embolisation, reicht die Embolisation mit Drahtspiralen aus.…”

“…nicht beherrschbarer Hypertonie bei Schrumpfnieren [11 -13] b. Nieren im Endstadium vor Nierentransplantation oder bei abgestoßener Transplantatniere [14 -16] c. therapierefraktärem nephrotischen Syndrom [11,13] d. Urinfisteln bei fortgeschrittener Tumorerkrankung im kleinen Becken als Ultima Ratio [11] e. dialysepflichtiger Niereninsuffizienz auf dem Boden autosomal dominanter Nierenzysten zur Behandlung von Kompressionseffekten [17] ralem Verschluss der Nierenarterien wurden aber beschrieben [25]. So konnte auch in einer tierexperimentellen Studie gezeigt werden, dass nach primär technisch erfolgreicher Embolisation mit Edelstahlspiralen 15 -23 Tage nach Embolisation 7 von 10 okkludierten Nierensegmentarterien wieder perfundiert waren [26].…”

Renal artery coil embolization of a non-functional kidney: A novel method to treat resistant hypertension in paediatric patients

“…1 The most critical determinant the rate of the progression of renal failure 2,3 and cardiovascular mortality in children is the level of blood pressure control obtained. 4 Appropriate antihypertensive management contributes to better renal preservation and survival with onset of CKD in childhood. The other treatment modalities for resistant renovascular hypertension due to end stage renal disease (ESRD) include surgical nephrectomy, medical nephrectomy, and radiofrequency ablation of renal nerve supply.…”

Safety and Efficacy of Transarterial Nephrectomy as an Alternative to Surgical Nephrectomy

“…Renal artery embolization is a minimally invasive procedure which is being increasingly used for the treatment of a wide range of conditions (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13). The indications for renal artery embolization overlap with those for surgical nephrectomy, although the less invasive nature of the former is a major advantage.…”

“…Transarterial nephrectomy, i.e., complete renal artery embolization, has the potential to be used as an alternative to surgical nephrectomy with an expectation of complete infarction and non-function of the embolized kidney (2, 3, 4, 5, 6, 7, 8). There have been studies demonstrating transarterial nephrectomy as an alternative to surgery for patients with renal graft intolerance, end-stage kidneys associated with severe hypertension or proteinuria or non-functioning hydronephrotic kidneys (2, 3, 4, 5).…”