Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

Journal Article · Wed Feb 15 04:00:00 EST 2017 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-016-1473-4· OSTI ID:22645344

Gupta, Nakul ^[1]; Patel, Anish ^[2]; Ensor, Joe ^[3]; Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael ^[4]; Matin, Surena ^[5]; Gupta, Sanjay ^[4]

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1. Houston Methodist Hospital (United States)
2. The University of Texas Southwestern Medical Center (United States)
3. Houston Methodist Research Institute, The Houston Methodist Cancer Center (United States)
4. The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States)
5. The University of Texas MD Anderson Cancer Center, Department of Urology (United States)

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

• OSTI ID: 22645344
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 40; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BIOMEDICAL RADIOGRAPHY
CONTAINERS
FISTULAE
KIDNEYS
MEDICAL RECORDS
NEOPLASMS
NEPHRECTOMY
PAIN
PANCREAS
PATIENTS
REVIEWS
SOCIO-ECONOMIC FACTORS
VASCULAR DISEASES