Treatment of Massive Hemorrhage after Renal Biopsy with Percutaneous Arterial Obliteration

Abstract

Severe perirenal hemorrhage is a major, although rare, postbiopsy complication. We report a case of a 48-year-old man with a postbiopsy massive bleeding from a ramification of the renal artery supplying the lower pole of the left kidney. Treatment consisted of complete obliteration of the bleeding vessel by helding a percutaneous catether in wedge position during a renal arteriographyc study. Our case shows that percutaneous arterial obliteration is a successful procedure in treating postbiopsy renal hemorrhage, representing an effective alternative to surgical therapy.

Successful Treatment of Massive Hemorrhage after Percutaneous Renal Biopsy with Transcatheter Arterial Embolization

“…In most reported cases with mas sive hemorrhage, surgical intervention occurred [3,4], Percutaneous transfemoral angiography and emboli zation have progressed and are now recognized as an alternative to surgery in managing life-threatening hem orrhage after renal biopsy. Embolization is advantageous to high-risk patients over surgical treatment and can reduce blood transfusions [5,9,10]. The adverse effects of therapeutic arterial embolization include two possible complications [11][12][13]: the unavoidable infarction of nearly 5-10% volume of the embolized kidney and an exacerbation of preexisting hypertension.…”

“…However, surgical interventions such as ne phrectomy and ligation of the renal artery were occasion ally required in a few cases. Severe hemorrhage is one of the major complications after percutaneous renal biopsy, occurring in less than 1 % of the performed biopsies [3,4], Recently, a case of massive renal hemorrhage after renal biopsy was successfully treated with percutaneous arterial obliteration and reported by Russo et al [5] as the first case.…”

Post-Renal Biopsy Acute Kidney Injury and Page Kidney from Intra-Renal Hematoma Aggravated by Reversible Contrast-Induced Nephropathy Following Renal Arterial Embolization

“…Nevertheless, more recent reports of Page kidney resulting from intrarenal pathology, such as cysts, tumors, and hematomas, have been described [2,5,6]. Bleeding complications after percutaneous kidney biopsy, albeit low, has been well described [7][8][9][10][11][12]. More recently, there has been an increasing use of super-selective renal artery embolization for the management of post-biopsy renal bleeding [13].…”