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Clinical Results of Transarterial Embolization to Control Postoperative Vascular Complications after Partial Nephrectomy

 Shin, Jaeseung  ;  Han, Kichang  ;  Kwon, Joon Ho  ;  Kim, Gyoung Min  ;  Kim, Doyoung  ;  Han, Seung Chul  ;  Kim, Hee Joon  ;  Won, Jong Yun  ;  Kim, Man-Deuk  ;  Lee, Do Yun 
 Journal of Urology, Vol.201(4) : 702-708, 2019 
Journal Title
 Journal of Urology 
Issue Date
Adult ; Aged ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/methods* ; Female ; Humans ; Male ; Middle Aged ; Nephrectomy*/methods ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control* ; Renal Artery ; Retrospective Studies ; Treatment Outcome ; Vascular Diseases/etiology ; Vascular Diseases/prevention & control*
PURPOSE: We evaluated the safety and clinical efficacy of transarterial embolization of vascular complications after partial nephrectomy. MATERIALS AND METHODS: This retrospective study included 1,187 patients who underwent partial nephrectomy between January 2006 and December 2017. A total of 36 patients were referred to the interventional radiology department for vascular complications after partial nephrectomy. Data on demographics, clinical manifestations, angiographic findings, the embolization procedure, perioperative details, and technical and clinical success rates were analyzed. Further, renal function was recorded at diagnosis, after embolization and at the last followup. RESULTS: Hemorrhage was diagnosed a median of 5 days (range 0 to 89) postoperatively. The incidence of requiring embolization due to hemorrhage after laparoscopic surgery (5.9% or 17 of 289 cases) was higher than that after open surgery (1.8% or 8 of 440, p = 0.003) and robot-assisted surgery (2.4% or 11 of 458, p = 0.014). The technical and clinical success rates were 100% (36 of 36 patients) and 94.4% (34 of 36) with 2 patients requiring additional embolization with n-butyl-2-cyanoacrylate glue. The mean ± SD estimated glomerular filtration rate at diagnosis, after embolization and at last followup was 81.0 ± 21.6, 83.7 ± 21.0 and 84.9 ± 15.8 ml/minute/1.73 m2, respectively (p = 0.345). No major complication was observed during followup. CONCLUSIONS: Transarterial embolization is safe and effective for managing vascular complications after partial nephrectomy. Moreover, renal function was well preserved with super selective transarterial embolization.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Joon Ho(권준호) ORCID logo https://orcid.org/0000-0002-6178-7252
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Shin, Jaeseung(신재승) ORCID logo https://orcid.org/0000-0002-6755-4732
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
Han, Ki Chang(한기창) ORCID logo https://orcid.org/0000-0002-9701-9757
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