Perkütan Nefrolitotomi Sonrası Oluşan Renal Arter Psödoanevrizmanın Tedavisinde Selektif Mikrokateter Koil Embolizasyonunun Değerlendirilmesi

Abstract

To investigate the technical success of selective microcatheter coil embolization for the treatment of distal renal artery pseudoaneurysm and to determine the effect of parenchymal loss on renal function. Material and Methods: In this study, the medical files and imaging records of 516 patients who underwent percutaneous nephrolithotomy at our clinic from May 2015 to December 2018 were retrospectively reviewed. Eight (1.55%) patients with renal artery pseudoaneurysms were included in the study. Preoperative and postoperative serum urea, hemoglobin and GFR values were recorded. These data were compared statistically and the effect of parenchymal loss on renal function was evaluated. The technical success of the treatment was accepted as the absence of contrast filling after embolization and clinical success was accepted as the absence of hematuria. Results: Eight patients with renal artery pseudoaneurysm were included in the study. All of the aneurysms originated from the distal renal artery (interlobar / interlobuler). The mean size of the aneurysms was 23.25 (9-38) mm. The technical and clinical success rates of microcatheter embolization were 100%. Macroscopic hematuria disappeared at a mean of 2.8 days after treatment. Five patients had <5% parenchymal loss, two had 5-10% and one patient had 25-50%. There was no statistically significant difference between plasma hemoglobin, urea and GRF before and after embolization (p = 0.814, 0.076, 0.263, respectively). Conclusion: Selective microcatheter coil embolization is a safe and effective method for the treatment of renal artery pseudoaneurysms after percutaneous nephrolithotomy.