Renal Artery Embolization - A First Line Treatment Option For End-Stage Hydronephrosis

Journal Article · Wed Sep 15 04:00:00 EDT 2004 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-003-1800-4· OSTI ID:21088280

Mitra, Kakali; Prabhudesai, Vikramaditya ^[1]; James, R Lester ^[2]; Jones, Robert W. A.; French, Michael E; Cowling, Mark; West, David J ^[1]

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1. Newcastle under Lyme ST4 6QG, University Hospital of North Staffordshire NHS Trust (United Kingdom)
2. Stafford ST16 S5A, Staffordshire General Hospital (United Kingdom)

Conventionally poorly functioning hydronephrotic kidneys have been removed if they are symptomatic. In our unit, patients are offered renal artery embolization as an alternative treatment option. Patients and Methods: Fifteen patients (11 male, 4 female) with a mean age of 32.9 yr (20-51 yrs) have undergone renal artery embolization for symptomatic hydronephrosis with poor function. Mean follow-up was 64.13 weeks (range 14-200). All patients had loin pain and hydronephrosis. Twelve patients had primary pelvi-ureteric junction obstruction (PUJO). Two patients had poorly functioning hydronephrotic kidneys secondary to chronic calculous obstruction. One patient had chronic pain in an obstructed but reasonably functioning kidney following a previous pyeloplasty for PUJO which demanded intervention. Mean split function on renography was 11% (range 0-46%). Selective renal artery embolization was carried out under antibiotic cover using a 7 Fr balloon occlusion catheter and absolute alcohol, steel coils, and polyvinyl alcohol particles.Results: Nine patients developed post-embolization syndrome of self-limiting pain and pyrexia with no evidence of sepsis. One patient required readmission with this condition. One patient developed a hematoma at the puncture site. Mean hospital stay was 2.3 days. Fourteen patients are happy with the result and are completely pain free. One patient has minor discomfort but is delighted with the result. Nine patients have had follow-up ultrasound confirming resolution of the hydronephrosis. Conclusion: Renal artery embolization is an effective, safe, well-tolerated minimally invasive treatment option in end-stage hydronephrosis and we routinely offer it as an alternative to nephrectomy.

• OSTI ID: 21088280
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 3 Vol. 27; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANTIBIOTICS
ARTERIES
HEMATOMAS
KIDNEYS
NEPHRECTOMY
PAIN
PATIENTS
PVA
RENOGRAPHY