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

Abstract

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 multiplemore » 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.« less

Authors:
 [1];  [2];  [3]; ; ; ; ; ; ; ; ; ; ;  [4];  [5];  [4]
  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)
Publication Date:
OSTI Identifier:
22645344
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 2; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BIOMEDICAL RADIOGRAPHY; CONTAINERS; FISTULAE; KIDNEYS; MEDICAL RECORDS; NEOPLASMS; NEPHRECTOMY; PAIN; PANCREAS; PATIENTS; REVIEWS; SOCIO-ECONOMIC FACTORS; VASCULAR DISEASES

Citation Formats

Gupta, Nakul, Patel, Anish, Ensor, Joe, Ahrar, Kamran, Ahrar, Judy, Tam, Alda, Odisio, Bruno, Huang, Stephen, Murthy, Ravi, Mahvash, Armeen, Avritscher, Rony, McRae, Stephen, Sabir, Sharjeel, Wallace, Michael, Matin, Surena, and Gupta, Sanjay, E-mail: sgupta@mdanderson.org. Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1473-4.
Gupta, Nakul, Patel, Anish, Ensor, Joe, Ahrar, Kamran, Ahrar, Judy, Tam, Alda, Odisio, Bruno, Huang, Stephen, Murthy, Ravi, Mahvash, Armeen, Avritscher, Rony, McRae, Stephen, Sabir, Sharjeel, Wallace, Michael, Matin, Surena, & Gupta, Sanjay, E-mail: sgupta@mdanderson.org. Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores. United States. doi:10.1007/S00270-016-1473-4.
Gupta, Nakul, Patel, Anish, Ensor, Joe, Ahrar, Kamran, Ahrar, Judy, Tam, Alda, Odisio, Bruno, Huang, Stephen, Murthy, Ravi, Mahvash, Armeen, Avritscher, Rony, McRae, Stephen, Sabir, Sharjeel, Wallace, Michael, Matin, Surena, and Gupta, Sanjay, E-mail: sgupta@mdanderson.org. Wed . "Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores". United States. doi:10.1007/S00270-016-1473-4.
@article{osti_22645344,
title = {Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores},
author = {Gupta, Nakul and Patel, Anish and Ensor, Joe and Ahrar, Kamran and Ahrar, Judy and Tam, Alda and Odisio, Bruno and Huang, Stephen and Murthy, Ravi and Mahvash, Armeen and Avritscher, Rony and McRae, Stephen and Sabir, Sharjeel and Wallace, Michael and Matin, Surena and Gupta, Sanjay, E-mail: sgupta@mdanderson.org},
abstractNote = {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.},
doi = {10.1007/S00270-016-1473-4},
journal = {Cardiovascular and Interventional Radiology},
number = 2,
volume = 40,
place = {United States},
year = {Wed Feb 15 00:00:00 EST 2017},
month = {Wed Feb 15 00:00:00 EST 2017}
}