Transcatheter arterial embolization with medical glue for the treatment of renal pseudoaneurysm:analysis of therapeutic effect / 介入放射学杂志

ABSTRACT

Objective To assess the clinical safety and effectiveness of transcatheter arterial embolization by using liquid medical glue ( FLA ) and super-selective catheterization technique in treating renal artery pseudoaneurysm. Methods During the period from Oct. 2009 to Jun. 2014, a total of 23 patients with angiography-proved renal pseudoaneurysm were treated with transcatheter arterial FLA embolization at authors’ hospital. The clinical data were retrospectively analyzed. A total of 28 pseudoaneurysms were detected in the 23 patients, which was caused by iatrogenic injury(18 cases, 21 lesions) or trauma(5 cases, 7 lesions). Super-selective catheterization with 3F micro-catheter was carried out. The micro-catheter was inserted into the parent artery of the pseudoaneurysm, which was followed by angiography. Once the pseudoaneurysm was confirmed by angiography, the mixture of FAL and iodized oil (1 ∶ 1) was injected into the pseudoaneurysm through the micro-catheter. The technical success rate, postoperative hematuria and renal function were determined. Results Successful embolization was achieved for all 28 pseudoaneurysms in 23 patients. The average volume of FAL used in embolization was 0.4 ml (0.2-1 ml). Ectopic embolization of the third-level vessel branches near the parent artery occurred in three cases , while no embolization of second-level vessel branch was observed. Persistent hematuria was seen in one patient even at two days after the treatment, whose pseudoaneurysm’s diameter was >2 cm, and embolization treatment with steel coil had to be performed, and bleeding stopped after the second treatment. During the follow-up period lasting for 3 months, no recurrence of hematuria was seen in the remaining patients. Mild elevation of serum creatinine after the treatment was observed in 4 patients. Conclusion The results of this study indicate that FAL together with the help of micro-catheter super-selective catheterization can effectively and reliably obstruct renal pseudoaneurysm with higher technical success rate and lower re-bleeding rate.