Clinical outcomes after emergency transarterial renal embolization: a retrospective study

Studies on emergency transarterial embolization (TAE) of renal arterial injuries are rare. The aim of this retrospective study was to evaluate clinical outcomes after emergency transarterial renal embolization.

Between January 1st, 2013 and January 1st, 2024, all consecutive patients treated for renal arterial injuries by TAE in emergency settings were retrospectively reviewed. Demographic, biological and angiographic data were recorded. The inclusion criteria were all patients ≥ 18-years-old treated by emergency TAE for renal vascular injury. Clinical success was defined as the resolution of bleeding signs without the need for repeat TAE, surgery, death related to massive blood loss during this period, without functional impairment (> 50% of parenchyma volume or onset of chronic kidney disease) following TAE.

During the inclusion period, 79 procedures were performed. The median age was 60[39-73] years old. On preoperative CT, ≥ 1 pseudoaneurysm was detected in 36(45.6%) patients, and active bleeding in 47(65.8%) patients. The preoperative median haemoglobin rate was 8.9[7.6-11] g/dl, and 37(46.8%) patients required red blood cell transfusions. The main aetiologies of arterial injury were blunt trauma (n = 19) and renal biopsy (n = 17). No severe adverse events were reported. Clinical success was reported in 74(93.7%) of the procedures. Three (3.8%) repeat embolizations were required, and were clinically successful. During the median follow-up of 7[1.5-35.5] months, 9(11.4%) patients died, of which 5(6.3%) occurred within 30 days.

The present study reports high clinical success, low complications and low rebleeding rates of emergency renal TAE.