Renal Artery Embolization for Renal Biopsy Bleed

Percutaneous renal biopsies (PRBs) provide useful information in determining diagnosis, prognosis, and treatment plans for patients with renal disease. The procedure is considered relatively safe with low rates of complications, which include bleeding (rarely leading to death), extended duration of pain, arteriovenous fistula formation, and others. When patients experience postprocedural bleeding, renal arteriography and renal artery embolization (RAE) may be performed. Embolic agents used may include sterile compressed sponge (Gelfoam; Surgifoam, Ethicon, Somerville, NJ), polyvinyl alcohol (PVA) particles, microcoils, or n-butyl cyanoacrylate (nBCA). Success rates are high, and with careful selection of small vessels, kidney function can often be preserved.

• References

• 1 Richards NT, Darby S, Howie AJ, Adu D, Michael J. Knowledge of renal histology alters patient management in over 40% of cases. Nephrol Dial Transplant 1994; 9 (9) 1255-1259
• 2 Madaio MP. Renal biopsy. Kidney Int 1990; 38 (3) 529-543
• 3 Appel GB. Renal biopsy: how effective, what technique, and how safe. J Nephrol 1993; 6: 4
• 4 Whittier WL, Korbet SM. Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol 2004; 15 (1) 142-147
• 5 Mavili E, Dönmez H, Ozcan N, Sipahioğlu M, Demirtaş A. Transarterial embolization for renal arterial bleeding. Diagn Interv Radiol 2009; 15 (2) 143-147
• 6 Sauk S, Zuckerman DA. Renal artery embolization. Semin Intervent Radiol 2011; 28 (4) 396-406
• 7 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 (7) 560-565
• 8 Davidson GS, Terbrugge KG. Histologic long-term follow-up after embolization with polyvinyl alcohol particles. AJNR Am J Neuroradiol 1995; 16 (4, Suppl): 843-846
• 9 Dong Q, Schoenberg SO, Carlos RC , et al. Diagnosis of renal vascular disease with MR angiography. Radiographics 1999; 19 (6) 1535-1554
• 10 Ginat DT, Saad WE, Turba UC. Transcatheter renal artery embolization: clinical applications and techniques. Tech Vasc Interv Radiol 2009; 12 (4) 224-239
• 11 Schwartz MJ, Smith EB, Trost DW, Vaughan Jr ED. Renal artery embolization: clinical indications and experience from over 100 cases. BJU Int 2007; 99 (4) 881-886