Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement
Super-selective renal artery embolization is an increasingly popular technique for the management of traumatic, low-grade renal trauma. When performed in distal arterial branches, this intervention enables tissue preservation and arrest of hemorrhage, but it may not be practical in cases of multifoc...
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| Format: | Article |
| Language: | English |
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Korean Society of Traumatology
2021-09-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2020-0075.pdf |
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| author | Abhishek Jairam Bradley King Zachary Berman Gerant Rivera-Sanfeliz |
| author_facet | Abhishek Jairam Bradley King Zachary Berman Gerant Rivera-Sanfeliz |
| author_sort | Abhishek Jairam |
| collection | DOAJ |
| description | Super-selective renal artery embolization is an increasingly popular technique for the management of traumatic, low-grade renal trauma. When performed in distal arterial branches, this intervention enables tissue preservation and arrest of hemorrhage, but it may not be practical in cases of multifocal, high-grade renal injuries. In such cases, surgical nephrectomy remains the more common treatment modality to ensure hemodynamic control. We present the unique case of a patient who presented in hemorrhagic shock following a major trauma that resulted in a grade 5 renal injury treated with complete renal artery embolization using Gelfoam, resulting in hemodynamic stabilization. Interestingly, imaging 1 month after embolization revealed residual enhancement of the inferior pole of the kidney, suggesting reconstitution of flow and partial renal salvage. Ultimately, transcatheter “nephrectomy” with careful selection of a temporary embolic agent may serve as a safe and efficient alternative to surgical nephrectomy with the added possibility of preserving partial renal perfusion and function in the emergent setting. |
| format | Article |
| id | doaj-art-0eed3ecf110c40e6a90acb13a46c6655 |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-0eed3ecf110c40e6a90acb13a46c66552025-01-16T02:21:32ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832021-09-0134319820210.20408/jti.2020.00751092Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal EnhancementAbhishek Jairam0Bradley King1Zachary Berman2Gerant Rivera-Sanfeliz3 Department of Radiology, University of California, San Diego, La Jolla, CA, USA Department of Radiology, University of California, San Diego, La Jolla, CA, USA Department of Radiology, University of California, San Diego, La Jolla, CA, USA Department of Radiology, University of California, San Diego, La Jolla, CA, USASuper-selective renal artery embolization is an increasingly popular technique for the management of traumatic, low-grade renal trauma. When performed in distal arterial branches, this intervention enables tissue preservation and arrest of hemorrhage, but it may not be practical in cases of multifocal, high-grade renal injuries. In such cases, surgical nephrectomy remains the more common treatment modality to ensure hemodynamic control. We present the unique case of a patient who presented in hemorrhagic shock following a major trauma that resulted in a grade 5 renal injury treated with complete renal artery embolization using Gelfoam, resulting in hemodynamic stabilization. Interestingly, imaging 1 month after embolization revealed residual enhancement of the inferior pole of the kidney, suggesting reconstitution of flow and partial renal salvage. Ultimately, transcatheter “nephrectomy” with careful selection of a temporary embolic agent may serve as a safe and efficient alternative to surgical nephrectomy with the added possibility of preserving partial renal perfusion and function in the emergent setting.http://jtraumainj.org/upload/pdf/jti-2020-0075.pdfrenal traumanephrectomyembolizationgel foam |
| spellingShingle | Abhishek Jairam Bradley King Zachary Berman Gerant Rivera-Sanfeliz Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement Journal of Trauma and Injury renal trauma nephrectomy embolization gel foam |
| title | Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement |
| title_full | Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement |
| title_fullStr | Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement |
| title_full_unstemmed | Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement |
| title_short | Non-Permanent Transcatheter Proximal Renal Artery Embolization for a Grade 5 Renal Injury with Delayed Recanalization and Preserved Renal Parenchymal Enhancement |
| title_sort | non permanent transcatheter proximal renal artery embolization for a grade 5 renal injury with delayed recanalization and preserved renal parenchymal enhancement |
| topic | renal trauma nephrectomy embolization gel foam |
| url | http://jtraumainj.org/upload/pdf/jti-2020-0075.pdf |
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