Selective renal artery embolization following blunt renal trauma: case report and current treatment recommendations...

Management of renal trauma has become more conservative as newer techniques evolve. In 2004, the Renal Trauma Subcommittee modified their algorithms for the management of renal injuries to include selective angiography and embolization for grade III and IV lacerations for both blunt and penetrating renal lacerations. These algorithms are based on the renal organ injury scale defined by The American Association for the Surgery of Trauma (AAST) and whether the patient is hemodynamically stable or unstable (Table 1). Historically, grade III and IV renal injuries would have been managed by renal exploration. The goals of treating patients with severe renal injuries are to prevent significant hemorrhage and retain sufficient functional nephrons to prevent end-stage kidney failure. Selective arterial embolization provides a minimally invasive treatment option for renovascular injuries and potentially obviates the need for surgical exploration with its higher incidence of nephrectomy. We present a case of grade IV renal laceration following blunt renal trauma, which was successfully treated with selective renal arterial embolization.