Pseudoaneurisma arteria renal postnefrectomía parcial: Tratamiento exitoso con embolización selectiva

C, Octavio Castillo; M, Jorge Díaz; A, Eduardo Caffarena; C, Manuel Díaz; M, Jorge Hoyos

doi:10.4067/s0718-40262006000500013

Cited by 3 publications

(4 citation statements)

References 2 publications

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“…But can be related to penetrating trauma and more rarely blunt trauma. (4)(5). Although it may be spontaneous as described in this case without history of trauma, renal surgery, percutaneous procedures, as well as inflammatory and neoplastic processes within the kidney.…”

Section: Introductionmentioning

confidence: 74%

Spontaneous Renal Artery Pseudoaneurysm Treated By Arterial Embolization

Habib¹,

Ayyad²,

Balosha³

2020

JCIIR

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Renal artery pseudoaneurysm is a rare vascular lesion. It is found with increasing frequency as a result of unrelated abdominal imaging or on work-up for hypertension. The pseudoaneurysm can be defined as a pulsatile hematoma that communicates with the artery through a small hole in the arterial wall. However, the rupture of pseudoaneurysmis the most dreaded complication because it causes death. There are many causes of renal artery pseudoaneurysm and are generally related to renal biopsy, nephrectomy or percutaneous procedures. In addition, there is a relationship with penetrating traumas and, more rarely, with blunt traumas. We report a case of renal artery pseudoaneurysm treated successfully with vascular plug embolization. A 22-year-old woman with hypertension presented with an incidental left renal artery pseudoaneurysm measuring 35x23 mm. We successfully performed endovascular treatment with vascular plug embolization without any complications.

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Section: Introductionmentioning

confidence: 74%

Spontaneous Renal Artery Pseudoaneurysm Treated By Arterial Embolization

Habib¹,

Ayyad²,

Balosha³

2020

JCIIR

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“…1 Qualquer lesão arterial penetrante pode resultar em formação de pseudoaneurismas, incluindo cirurgia reconstrutiva vascular, punção inadvertida por usuários de drogas intravenosa, trauma fechado, fixação interna ortopédica, bem como intervenções percutâneas ou vasculares. 2 A incidência de pseudoaneurisma iatrogênico aumentou devido à crescente prevalência de procedimentos intervencionistas periféricos, cateterismo cardíaco transarterial e biópsias guiadas por imagens. Eles ocorrem em 0,1%-0,2% dos angiogramas de diagnóstico e 3,5%-5,5% dos procedimentos de intervenção.…”

Section: Discussionunclassified

“…O Pseudoaneurisma da Artéria Renal (PAR) é uma complicação vascular rara, a qual está associada etiologicamente com nefrectomia parcial, procedimentos percutâneos, biópsia renal, trauma penetrante e, mais raramente, trauma contuso. [1][2][3] Dentre as causas, as traumáticas ou iatrogênicas são as mais frequentes. 4 Para o diagnóstico dessa lesão vascular, existem vários exames complementares disponíveis como a ultrassonografia com Doppler, arteriografia, angiotomografia, cintilografia renal e a ressonância magnética.…”

Section: Introductionunclassified

“…4 Para o diagnóstico dessa lesão vascular, existem vários exames complementares disponíveis como a ultrassonografia com Doppler, arteriografia, angiotomografia, cintilografia renal e a ressonância magnética. 2,3 Para o tratamento, pode-se citar seis modalidades: expectante, cirúrgico, compressão, injeção de salina, embolização com mola, injeção de trombina, sendo a embolização a indicada para aqueles de menores dimensões em pacientes estáveis hemodinamicamente.…”

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Tratamento endovascular embolizante de pseudoaneurisma em rim transplantado

Soares

Filho

et al. 2020

Rev. Med. UFC

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O pseudoaneurisma de artéria renal é uma complicação vascular que pode ocorrer após procedimentos percutâneos, nefrectomia, traumas penetrantes e traumas contusos, este de difícil ocorrência. Os sinais e sintomas são inespecíficos e podem variar com cada paciente, sendo a hematúria o sintoma mais comum. Com isso, faz-se necessário um bom entendimento do histórico médico do paciente para suspeição clínica. A tomografia computadorizada e o ecodoppler podem ser usados como auxílio ao diagnóstico. Neste relato, apresentamos o caso de um paciente submetido à transplante renal com enxertia em vasos ilíacos à esquerda, evoluiu com piora de função renal sendo submetido a biópsia renal. O quadro progrediu com queda do hematócrito e piora da função renal, sendo submetido a ultrassom com Doppler de rim transplantado que evidenciou formação anecóica pulsátil. A tomografia mostrou extravasamento de contraste no parênquima do enxerto renal. Foi optado, então, por tratamento endovascular de pseudoaneurisma em enxerto renal com molas. O paciente evoluiu no pós-operatório com resolução da dor em fossa ilíaca esquerda, e melhora de função renal.

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Renal Artery Pseudo-aneurysms: Do All of Them Require Endovascular Management?

Choh

Bhat

Shah

et al. 2021

JGR

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Purpose: Our study examines the etiological profile, clinical and imaging features of renal artery pseudo aneurysms (RAPs), as well as the efficacy and need for the angioembolization of RAPs in a resource-constrained setting. Materials and Methods: A total of 36 patients with RAPs were included in our study. Initial diagnosis was made by Doppler Ultrasonography (USG) followed by CT renal angiography in all cases. DSA was performed in 28 patients, as eight patients showed spontaneous resolution by thrombosis on immediate pre-procedure Doppler study. Angioembolization with a microcoil was performed for 30 aneurysms in 28 patients. Technical success was confirmed at the end of the procedure by a renal angiogram. To assess clinical success, we followed up with patients (with clinical and Doppler USG) for a period of six months. Results: The most common cause of RAPs in our study was percutaneous nephrolithotomy (PCNL), seen in 21 patients (58.3%), followed by trauma (25%), and partial nephrectomy (11%). All patients presented to us were within 21 days of the etiological event of hematuria or flank pain. USG was able to detect the RAP in 22 cases (61%). CT renal angiography was diagnostic in all patients but failed to demonstrate two additional aneurysms in one patient. RAP size ≤ 4 mm and absence of brisk filling on CT renal angiography was associated with spontaneous resolution in eight patients, probably an indication of the beginning of spontaneous thrombosis. Angioembolization was done using microcoils and showed 100% technical and clinical success. Conclusion: PCNL is the most common etiological factor for RAPs in our setting. Such patients should have a Doppler USG done prior to discharge from the hospital. CT angiographic flow dynamics (delayed peak enhancement) may be helpful in the identification of RAPs with a high probability of subsequent spontaneous resolution. Angiography followed by embolization using microcoils is the most effective and safe treatment for RAPs with no significant loss of renal parenchyma, although cost remains a limiting factor in our setting.

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Pseudoaneurisma arteria renal postnefrectomía parcial: Tratamiento exitoso con embolización selectiva

Cited by 3 publications

References 2 publications

Spontaneous Renal Artery Pseudoaneurysm Treated By Arterial Embolization

Spontaneous Renal Artery Pseudoaneurysm Treated By Arterial Embolization

Tratamento endovascular embolizante de pseudoaneurisma em rim transplantado

Renal Artery Pseudo-aneurysms: Do All of Them Require Endovascular Management?

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