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Article

Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors

  • Authors:
    • Qiqi Mao
    • Chaojun Wang
    • Geming Chen
    • Fuqing Tan
    • Bohua Shen
  • View Affiliations / Copyright

    Affiliations: Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
  • Pages: 4151-4156
    |
    Published online on: September 20, 2019
       https://doi.org/10.3892/etm.2019.8033
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Abstract

Superselective renal arterial embolization (SRAE) is a well‑established method for the treatment of severe hemorrhage following percutaneous nephrolithotomy (PCNL). However, there remains a significant rate of failures requiring repeat SRAE or nephrectomy. To identify risk factors for initial treatment failure of SRAE, the data of patients who had undergone SRAE for severe bleeding due to PCNL between August 2005 and June 2016 were retrospectively analyzed. A total of 98 patients required SRAE for bleeding control following PCNL. Renal arteriography revealed pseudoaneurysm in 65 patients, arteriovenous fistula in 6 patients, and a combination of both in 11 patients. Free extravasation was observed in 11 patients; 8 of these patients exhibited coexisting pseudoaneurysm. Vascular aberration/tortuosity was identified in 10 patients. A total of 17 patients (17.3%) experienced initial treatment failure and underwent repeat SRAE. Multivariate analysis identified percutaneous tract size, number of bleeding sites and vascular aberration/tortuosity as significant predictors of initial treatment failure. The results from the present study suggested that repeated SRAE is preferred for patients who have experienced initial treatment failure with recurrent hemorrhage following PCNL. Large tract size, multiple bleeding sites and renal vascular aberration/tortuosity were significantly associated with increased risk of initial treatment failure of SRAE. These data may assist interventional radiologists in the planning and execution of SRAE in the treatment of PCNL.
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Copy and paste a formatted citation
Spandidos Publications style
Mao Q, Wang C, Chen G, Tan F and Shen B: Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors. Exp Ther Med 18: 4151-4156, 2019.
APA
Mao, Q., Wang, C., Chen, G., Tan, F., & Shen, B. (2019). Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors. Experimental and Therapeutic Medicine, 18, 4151-4156. https://doi.org/10.3892/etm.2019.8033
MLA
Mao, Q., Wang, C., Chen, G., Tan, F., Shen, B."Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors". Experimental and Therapeutic Medicine 18.5 (2019): 4151-4156.
Chicago
Mao, Q., Wang, C., Chen, G., Tan, F., Shen, B."Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors". Experimental and Therapeutic Medicine 18, no. 5 (2019): 4151-4156. https://doi.org/10.3892/etm.2019.8033
Copy and paste a formatted citation
x
Spandidos Publications style
Mao Q, Wang C, Chen G, Tan F and Shen B: Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors. Exp Ther Med 18: 4151-4156, 2019.
APA
Mao, Q., Wang, C., Chen, G., Tan, F., & Shen, B. (2019). Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors. Experimental and Therapeutic Medicine, 18, 4151-4156. https://doi.org/10.3892/etm.2019.8033
MLA
Mao, Q., Wang, C., Chen, G., Tan, F., Shen, B."Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors". Experimental and Therapeutic Medicine 18.5 (2019): 4151-4156.
Chicago
Mao, Q., Wang, C., Chen, G., Tan, F., Shen, B."Failure of initial superselective renal arterial embolization in the treatment of renal hemorrhage after percutaneous nephrolithotomy: A respective analysis of risk factors". Experimental and Therapeutic Medicine 18, no. 5 (2019): 4151-4156. https://doi.org/10.3892/etm.2019.8033
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