Gas formation after renal artery embolisation: genesis and clinical relevance

Preoperative embolisation of renal carcinomas has several pros and cons for the patient. The negative aspects can be summarized as 'post-infarction' syndrome'. Radiologically, intrarenal gas formation is always evident. As sterile breakdown products of tumor cell necrosis these have to be interpreted as regular postinterventional findings and not as indicators for infection or even sepsis. Tumor embolisation as a means to reduce surgical difficulties in large hypervascularized renal carcinomas and also as a palliative measure in marked macrohematuria and/or tumor-induced flank pain is thus very conceivable. The best time for the tumor-nephrectomy is the day of embolisation or the first postinterventional day. This makes the nephrectomy easier and prevents the postinfarction syndrome for the patient.