Efficacy and safety of endovascular treatment for iatrogenic renal injuries following percutaneous interventions.

INTRODUCTION

Renal artery embolization (RAE) is a minimally-invasive therapeutic option for iatrogenic renal vascular injuries (IRVIs).

AIM: We aimed to assess the efficacy and safety of RAE in treating IRVIs resulting from percutaneous interventions.

MATERIALS AND

METHODS

The study included 34 patients (25 men, 9 women; mean [SD] age, 49.1 [18.9] years) who were treated with RAE for IRVIs at our center between February 2019 and May 2025. The etiology and type of IRVIs, hemoglobin levels, accompanying radiological findings, and parameters related to the RAE procedure were retrospectively analyzed.

RESULTS

Among the 34 patients, the etiology of IRVI was percutaneous biopsy in 17 individuals and percutaneous nephrolithotomy in the remaining 17 cases. A total of 35 RAE procedures were performed (1 reintervention). The IRVIs were classified as active extravasation (n = 24), pseudoaneurysm (n = 9), and arteriovenous fistula (n = 2). Parenchymal laceration was observed in 10 patients, and a collecting system injury was noted in 1 individual. The embolic agents used were coils (49%), N-butyl cyanoacrylate mixed with lipiodol (28%), polyvinyl alcohol (PVA) particles (14%), a combination of coils, glue, and lipiodol (6%), and a combination of PVA particles and coils (3%). The technical success rate was 100%, while the clinical success rate was 97%. Only 1 patient required reintervention due to persistent hemorrhage. Minor complications occurred in 3 patients, and no major complications were observed.

CONCLUSIONS

RAE is a safe, highly effective, and minimally-invasive treatment for IRVIs. The procedure offers additional advantages, including nephron preservation and the potential for repeat intervention, if necessary.