Renal function outcomes following selective angioembolization for iatrogenic vascular lesions after partial...

Area of Science:

• Urology
• Interventional Radiology
• Nephrology

Background:

• Iatrogenic vascular lesions (IVL) can occur after partial nephrectomy (PN).
• Angioembolization (AE) is the standard treatment for these vascular complications.
• The impact of AE on renal function after PN is not well-documented.

Purpose of the Study:

• To evaluate clinical and renal function outcomes in patients treated with AE for IVL after PN.
• To assess the safety and efficacy of AE in managing post-PN hemorrhage.
• To describe the effect of AE on estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) progression.

Main Methods:

• Retrospective review of patients undergoing PN (2002-2012) who developed IVL and were treated with AE.
• Analysis of renal function using eGFR and CKD classification before and after PN and AE.
• Assessment of AE technical success and need for repeat procedures.

Main Results:

• 28 of 849 PN patients (3.3%) developed IVL, with 71% presenting with gross hematuria.
• AE technical success was 86%, with 4 patients requiring repeat AE.
• No significant change in eGFR was observed after AE at short-term or intermediate-term follow-up.
• Most patients maintained or improved their CKD classification post-AE.

Conclusions:

• Selective AE is a safe and effective treatment for IVL following PN.
• AE does not lead to significant renal function decline in this patient cohort.
• AE is the preferred management strategy for post-PN bleeding due to IVL.