Traumatic renal arteriovenous fistula in a 3-year-old girl, successfully treated by percutaneous transluminal embolization

Zee, J. A. van der; Hoek, J. van den; Weerts, Jan G.E.

doi:10.1016/0022-3468(95)90426-3

Cited by 15 publications

(7 citation statements)

References 3 publications

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“…Previous case reports or case series of patients who underwent renal artery embolization procedures reported that new-onset hypertension may occur, while renal function was neither well documented nor systematically followed. [8][9][10][11][12][13][14][15][16][17][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] The best available evidence for blood pressure and renal function outcomes data in patients who had therapeutic renal artery embolization prior to this study comes from a retrospective study by Jacobson et al, 9 which included 36 patients who had a total of 44 procedures. In that study, 14 of 36 patients (39%) had total or partial nephrectomies; renal artery embolization was a secondary therapeutic procedure, which was used to treat surgical complications, such as postnephrectomy bleeding.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of Renal Function and Blood Pressure After Selective Renal Arterial Embolization

Collins

Eggert

Stanson

et al. 2010

Perspectives in Vascular Surgery and Endovascular Therapy

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Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of Renal Function and Blood Pressure After Selective Renal Arterial Embolization

Collins

Eggert

Stanson

et al. 2010

Perspectives in Vascular Surgery and Endovascular Therapy

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“…26, No. 3 procedures to TAE TAE van der Zee et al [36] El-Sherbıny et al [40] Meissnitzer et al [38] Vo NJ et al [28] cases, and this rate is declining day by day due to increasing the availability of minimally invasive treatment procedures. [8] Surgical treatment is usually preferred in hemodynamically unstable patients or patients with renal vascular pedicle injury, ureteropelvic junction injury or in the setting of failed conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter embolization in pediatric blunt renal trauma: Case report and review of the literature

Kartal¹

2019

Ulus Travma Acil Cerrahi Derg

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This study aims to evaluate the clinical use and outcomes of transcatheter embolization in the setting of pediatric blunt renal trauma cases using an index case and review of the literature. Although the treatment method selection depends on the grade of the trauma and the hemodynamıc status of the patient, conservative methods are considered initially in the setting of pediatric blunt renal trauma. Transcatheter embolization, which is a relatively conservative treatment option, is commonly utilized in adult blunt renal trauma patient population; however, experience in the pediatric population is scarce. A seven-year-old male patient was admitted due to grade IV renal injury secondary to blunt abdominal trauma. He was conservatively followed until -on the post-trauma day 15-he developed gross hematuria and an unstable hemodynamic status. A renal angiogram was performed, which revealed rightsided renal inferior segmental artery pseudoaneurysm and arterio-venous fistula. Subsequently, a transcatheter embolization was performed. There were no complications and no permanent renal injury. Review of the literature revealed that the success rate of transcatheter embolization is 89.47% in the setting of pediatric blunt abdominal trauma-related renal injury regardless of the renal trauma grade. Four patients underwent nephrectomy due to a failed transcatheter embolization procedure. There are not any patients who suffered from embolization-related complications. These results suggest that transcatheter embolization can be safely performed in children with renal injuries due to blunt abdominal trauma with high success and low complication rates and preservation of renal function.

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“…Pseudoaneurysm, which may cause a mass effect on the collecting system, hematuria, or extracapsular hemorrhage, may be evident as large, enhancing collection within the kidney on CT scan [138]. An AVF may present either in isolation [144] or in combination with a pseudoaneurysm (Fig. 12).…”

Section: Vascular Complicationsmentioning

confidence: 97%

“…For AVF or arteriocaliceal fistula occlusion, coils or microcoils properly sized to the feeding vessel are embolic agents of choice since they offer a better deployment control compared with gelfoam pledgets, and are less likely to pass through the fistula into the venous system than smaller particles or gelfoam pieces (Fig. 12) [144]. Renal bleeding control after embolization is achieved in 80-100% of patients [136,145].…”

Section: Vascular Complicationsmentioning

confidence: 99%

Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention)

Goffette

Laterre

2002

Eur Radiol

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The nonoperative management (NOM) of abdominal trauma has gained increasing acceptance over the past decade. This approach has been extended to severe trauma patients previously considered as candidates for surgery. Consequently, the incidence of delayed and uncommonly encountered complications has increased. Causes of delayed complications are multiple and include: (a) abnormal or insufficient injury healing process; (b) retention of necrotic tissue; (c) secondary infection of initially sterile collections; and (d) underestimation of injury severity. The purpose of this review article is to explain the role of various imaging modalities in detecting post-traumatic delayed complications and to highlight the usefulness of minimally invasive techniques, including laparoscopy, biliary endoscopy, therapeutic angiography and image-guided drainage. Subsequent complications, which do not necessarily negatively influence the final outcome, are often predictable, virtually obligatory consequences of the successful NOM of high-grade or complex abdominal injuries. Between 50 and 60% of those patients with grade-IV or grade-V liver or splenic lacerations require some type of interventional treatment; therefore, indiscriminate discharge of patients with solid organ injury managed conservatively may be potentially harmful. As the incidence of complications is higher for more severe grade-IV or grade-V liver, spleen, or kidney injuries, scheduled follow-up CT scans may be rational in this subset of patients to identify potential complications amenable to early application of interventional techniques. Follow-up CT scans are unnecessary in stable adults or children with low-grade injury. Delayed splenic or hepatic rupture is one of the major concerns because this type of complication remains difficult to predict and historically often requires emergent surgery. These ruptures may benefit from NOM, should the same criteria as for primary rupture be respected. Conversely, parenchymatous focal pooling of contrast on initial CT is a good predictor for the development of delayed vascular malformation. In children, as a large part of splenic and hepatic vascular malformations resolve spontaneously, expectant observation may be indicated provided that a strict imaging follow-up is performed until complete disappearance of these lesions. If needed, embolization of parenchymal vascular lesions should be performed as selectively as possible in order to avoid functional parenchyma loss and to reduce the risk of secondary infection of hematoma or ischemic tissue. Technical improvements, such as microcatheter systems and direct percutaneous approach to targeted lesions, have widened the potential for safe endovascular management of acquired vascular malformations. Advantages and disadvantages relative to the different embolic agents are explained. Endoscopic retrograde pancreatography is the chief investigational tool for detecting biliary and pancreatic ducts injuries. The respective roles of endoscopic, percutaneous and surgical approaches...

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Traumatic renal arteriovenous fistula in a 3-year-old girl, successfully treated by percutaneous transluminal embolization

Cited by 15 publications

References 3 publications

Long-Term Follow-Up of Renal Function and Blood Pressure After Selective Renal Arterial Embolization

Long-Term Follow-Up of Renal Function and Blood Pressure After Selective Renal Arterial Embolization

Transcatheter embolization in pediatric blunt renal trauma: Case report and review of the literature

Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention)

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