Polymer-glue as a life and kidney function saver: a life-threatening hemorrhage in the ruptured upper pole artery of the kidney managed by percutaneous embolization - a case report and literature review

• Authors: Artur Antoniewicz , Izabela Wojtkowska , Mirosław Dziekiewicz , Cezary Kępka , Elżbieta Kremis , Łukasz Zapała , Ryszard Skiba , Janina Stępińska
• Languages of publication: EN

Abstracts

EN

In this paper we report the case of a nearly fatal hemorrhage in the artery of the renal upper pole that occurred in a 84-year-old woman on anticoagulation treatment in connection with aortic valve replacement 4 days prior to the incident. The artery was injured during the evacuation of a hematoma of the right pleural cavity. While the patient was in the intensive care unit recovering from cardiac valve surgery, the consulting urologist was summoned in order to cope with massive hematuria and acute urine retention. Unfortunately, conservative urological management based on catherization via a three-way catheter and constant transurethral lavage with saline was unsuccessful. Angio-computed tomography revealed a ruptured branch of the renal upper pole artery. A highly selective embolization using histoacryl injection during percutaneous angioplasty was performed. There were no complications in the following days. The patient was subject to postoperative follow-up at 3, 6 and 9 months and renal scintigraphy was performed at 6 months revealing symmetrical function of both kidneys without any changes in the upper pole of the right kidney.

Keywords

EN

Polymer-glue; Percutaneous embolization; A life-threatening kidney hemorrhage

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2013
• Volume: 8
• Issue: 3
• Pages: 339-342

Dates

published

1 - 6 - 2013

online

17 - 4 - 2013

Contributors

author

Artur Antoniewicz

• Department of Urology, Multidisciplinary Hospital Warsaw-Miedzylesie, 2 Bursztynowa St., 04-749, Warsaw, Poland

author

Izabela Wojtkowska

• Department of Interventional Cardiology and Angiology, The Cardinal Stefan Wyszyński Institute of Cardiology, 42 Alpejska St., 04-628, Warsaw, Poland

author

Mirosław Dziekiewicz

• Department of General, Vascular and Oncological Surgery, Military Institute of Medicin, 128 Szaserów St., 04-141, Warsaw, Poland

author

Cezary Kępka

• Department of Interventional Cardiology and Angiology, The Cardinal Stefan Wyszyński Institute of Cardiology, 42 Alpejska St., 04-628, Warsaw, Poland

author

Elżbieta Kremis

• Department of Interventional Cardiology and Angiology, The Cardinal Stefan Wyszyński Institute of Cardiology, 42 Alpejska St., 04-628, Warsaw, Poland

author

Łukasz Zapała

• Department of Urology, Multidisciplinary Hospital Warsaw-Miedzylesie, 2 Bursztynowa St., 04-749, Warsaw, Poland

author

Ryszard Skiba

• Department of Urology, Multidisciplinary Hospital Warsaw-Miedzylesie, 2 Bursztynowa St., 04-749, Warsaw, Poland

author

Janina Stępińska

• Department of Interventional Cardiology and Angiology, The Cardinal Stefan Wyszyński Institute of Cardiology, 42 Alpejska St., 04-628, Warsaw, Poland

References

• [1] Somani BK, Nabi G, Thorpe P, McClinton S: Endovascular control of haemorrhagic urological emergencies: An observational study. BMC Urol 2006;6:27 http://dx.doi.org/10.1186/1471-2490-6-27[Crossref]
• [2] Poulakis V, Ferakis N, Becht E, Deliveliotis C, Duex M: Treatment of renal-vascular injury by transcatheter embolization: Immediate and long-term effects on renal function. J Endourol 2006;20:405–409 http://dx.doi.org/10.1089/end.2006.20.405[Crossref]
• [3] Mavili E, Donmez H, Ozcan N, Sipahioglu M, Demirtas A: Transarterial embolization for renal arterial bleeding. Diagn Interv Radiol 2009;15:143–147 [PubMed]
• [4] Albani JM, Novick AC: Renal artery pseudoaneurysm after partial nephrectomy: Three case reports and a literature review. Urology 2003;62:227–231 http://dx.doi.org/10.1016/S0090-4295(03)00364-9[Crossref]
• [5] Heye S, Maleux G, Van Poppel H, Oyen R, Wilms G: Hemorrhagic complications after nephron-sparing surgery: Angiographic diagnosis and management by transcatheter embolization. AJR Am J Roentgenol 2005;184:1661–1664 http://dx.doi.org/10.2214/ajr.184.5.01841661[Crossref]
• [6] Cantasdemir M, Adaletli I, Cebi D, Kantarci F, Selcuk ND, Numan F: Emergency endovascular embolization of traumatic intrarenal arterial pseudoaneurysms with n-butyl cyanoacrylate. Clin Radiol 2003;58:560–565 http://dx.doi.org/10.1016/S0009-9260(03)00135-1[Crossref]
• [7] White RI, Jr., Strandberg JV, Gross GS, Barth KH: Therapeutic embolization with long-term occluding agents and their effects on embolized tissues. Radiology 1977;125:677–687 [Crossref][PubMed]
• [8] Davidson GS, Terbrugge KG: Histologic long-term follow-up after embolization with polyvinyl alcohol particles. AJNR Am J Neuroradiol 1995;16:843–846 [PubMed]
• [9] Kish JW, Katz MD, Marx MV, Harrell DS, Hanks SE: N-butyl cyanoacrylate embolization for control of acute arterial hemorrhage. J Vasc Interv Radiol 2004;15:689–695 http://dx.doi.org/10.1097/01.RVI.0000133505.84588.8C[Crossref]
• [10] Pollak JS, White RI, Jr.: The use of cyanoacrylate adhesives in peripheral embolization. J Vasc Interv Radiol 2001;12:907–913 http://dx.doi.org/10.1016/S1051-0443(07)61568-1[Crossref]

Identifiers

DOI

10.2478/s11536-012-0085-x