Abstract:
Higher turnaround of urologic patients in the tertiary clinical center can lead to more accompanying complications, ranging from 1% to 55% for various procedures, with the incidence of vascular injuries varying from 0.43% up to 9.5%. In patients with impaired renal function, it is imperative to prevent the loss of normal kidney function and potential hemodialysis. Being minimally invasive, endovascular procedures such as renal artery embolization (RAE) can treat major and life-threatening complications, but good and prompt communication between urologists and interventional radiologist is necessary for fast and effective treatment. Absolute contraindications for RAE are the presence of acute infection and previously known anaphylactic reaction to the iodine contrast media, while previous mild or moderate allergic reactions to iodine contrast media are not contraindications for RAE. Currently used embolic agents can be divided into temporary and permanent embolization agents. While the temporary embolization agent available is a gelatin sponge that could be used as complementary material or stand-alone, for permanent embolization interventional radiologists use microparticles, microspheres, liquid embolic agents, coils, and microcoils. RAE procedures are considered to be safe with a low incidence of complications, with non-target embolization being the most serious one. Postembolization syndrome is considered to be the most common adverse effect and it involves around 90% of patients. The overall results show that RAE is a safe, minimally invasive procedure that can effectively treat significant complications caused by other urologic procedures, with the reported success rates of 87%-100%.
摘要:
三级临床中心泌尿科患者的高周转率可导致更多伴随并发症,各种程序的1%到55%不等,血管损伤的发生率从0.43%到9.5%不等。在肾功能受损的患者中,必须防止正常肾功能的丧失和潜在的血液透析。微创,血管内手术,如肾动脉栓塞(RAE)可以治疗严重和危及生命的并发症,但是泌尿科医师和介入放射科医师之间良好而及时的沟通对于快速有效的治疗是必要的。RAE的绝对禁忌症是存在急性感染和先前已知的对碘造影剂的过敏反应,而先前对碘造影剂的轻度或中度过敏反应不是RAE的禁忌症。目前使用的栓塞剂可分为暂时性栓塞剂和永久性栓塞剂。虽然可用的临时栓塞剂是明胶海绵,可用作补充材料或独立使用,对于永久性栓塞,介入放射科医生使用微粒,微球,液体栓塞剂,线圈,和微线圈。RAE手术被认为是安全的,并发症发生率低。非目标栓塞是最严重的。栓塞后综合征被认为是最常见的不良反应,涉及约90%的患者。总体结果表明,RAE是一种安全的,微创手术,可有效治疗其他泌尿外科手术引起的重大并发症,报告的成功率为87%-100%。