Long term renal function following selective angioembolization for iatrogenic vascular lesions after partial...

Area of Science:

• Urology
• Nephrology
• Interventional Radiology

Background:

• Partial nephrectomy carries a 1%-2% risk of iatrogenic vascular lesions (IVL).
• Selective angioembolization (SAE) is a common treatment for IVLs, theoretically preserving renal parenchyma.
• Concerns exist regarding the impact of contrast load from SAE on renal function.

Purpose of the Study:

• To evaluate the long-term effects of SAE on renal function following partial nephrectomy.
• To assess the safety and efficacy of SAE in managing IVLs.

Main Methods:

• Retrospective review of patients undergoing partial nephrectomy (2002-2018).
• 1:4 matched case-control analysis comparing patients with and without IVL.
• Multivariable regression analyses to identify risk factors for SAE and renal function outcomes.

Main Results:

• IVLs were more frequent after minimally invasive partial nephrectomy and in cases with higher RENAL nephrometry scores.
• Lower RENAL scores were associated with decreased odds of requiring SAE.
• No significant difference in renal function was observed at 24 months post-SAE.

Conclusions:

• SAE is a safe and effective treatment for IVLs after partial nephrectomy.
• SAE has no significant short or long-term impact on renal function.
• Less complex renal tumors (lower RENAL scores) are less likely to necessitate SAE.