Therapeutic renal infarction

Area of Science:

• Interventional Radiology
• Nephrology
• Oncology

Background:

• Hypernephroma (renal cell carcinoma) often requires nephrectomy.
• Pre-operative strategies aim to reduce surgical complications like blood loss.
• Renal infarction is a potential therapeutic intervention.

Purpose of the Study:

• To evaluate the efficacy and safety of pre-nephrectomy therapeutic renal infarction using gelfoam in hypernephroma patients.
• To assess the impact of this technique on surgical facilitation and blood loss.
• To document post-infarction complications and outcomes, including effects on blood pressure control in dialysis patients.

Main Methods:

• Ten patients with hypernephroma underwent therapeutic renal infarction via gelfoam injection into the renal artery.
• One dialysis patient received bilateral renal infarction.
• Outcomes including surgical facilitation, blood loss, post-infarction syndrome, and complications were monitored.

Main Results:

• Renal infarction facilitated nephrectomy and decreased blood loss in hypernephroma patients.
• Most patients experienced post-infarction syndrome (flank pain, fever, nausea).
• A dialysis patient showed improved blood pressure control after bilateral infarction, but suffered distal gelfoam embolization leading to foot gangrene.

Conclusions:

• Pre-nephrectomy renal infarction with gelfoam is a viable technique for hypernephroma, aiding surgery and reducing blood loss.
• Post-infarction syndrome is a common complication.
• Careful embolization technique is crucial to prevent serious complications like distal embolization and gangrene.