[Transcatheter arterial embolization for severely dysfunctioning kidney]

The authors performed Transcatheter Arterial Embolization (TAE) with pure ethanol in five cases of severely dysfunctioning kidneys, for which conventional surgical nephrectomy had been conducted. In 3 out of 5 cases, the dysfunctioning kidneys were complicated by renal hypertension, while the other two had the complication of refractory urinary fistula. 1. Single TAE trials in 4 out of 5 patients, and a secondary TAE trial in the remaining patient resulted in successful complete embolization of the kidneys. 2. The size of the kidney in the bidirectional measurement by CT after TAE was reduced markedly in all the five cases and the reduction rate of the kidney was from 89.29 to 62.84%, and 72.61% on the average. 3. Both the blood pressure (BP) and plasma renin activity (PRA) in the three patients with complicated renal hypertension were all normalized two weeks after the TAE. Twenty six months, 48 and 60 months have elapsed in these three cases and blood pressure has remained normal without antihypertensive agents. From this result it is considered that TAE will induce the reduction of juxtaglomerular cell functions. 4. Two patients with urinary fistula were healed. 5. TAE has a number of advantages over surgical nephrectomy in that it is bloodless and noninvasive. Further, the techniques of TAE are easier than nephrectomy and TAE is applicable to almost all poor risk patients.