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Semin intervent Radiol 2021; 38(01): 113-122
DOI: 10.1055/s-0041-1726006
Review Article

Interventional Radiology in Renal Trauma

Diego B. Lopez-Gonzalez
1   Division of Interventional Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
,
Omar Zurkiya
1   Division of Interventional Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
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Abstract

Traumatic injuries to the kidney and collecting system can range widely from small lacerations to significant bleeding and its sequelae. Urinary obstruction can occur in the renal pelvis, ureters, or urethra. Interventional radiology plays a significant role in treatment and management, in many cases requiring emergent action. Endovascular embolization is frequently the first-line approach to treating hemorrhage. Percutaneous interventions for urinary obstruction include nephrostomy and suprapubic catheter placement. In this article, we outline the clinical approach and interventional methods used in the evaluation and treatment of renal trauma. Several case presentations demonstrate the role of interventional radiology in renal trauma.

Keywords

interventional radiology - renal trauma - embolization - page kidney - renal hemorrhage


Publication History

Article published online:
15 April 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 WISQARS Leading Causes of Death Reports. . Accessed August 4, 2020 at: https://webappa.cdc.gov/sasweb/ncipc/leadcause.html
    PubMed
  • 2 Santucci RA, Wessells H, Bartsch G. et al. Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU Int 2004; 93 (07) 937-954
    CrossrefPubMedSearch in Google Scholar
  • 3 Smith J, Caldwell E, D'Amours S, Jalaludin B, Sugrue M. Abdominal trauma: a disease in evolution. ANZ J Surg 2005; 75 (09) 790-794
    CrossrefPubMedSearch in Google Scholar
  • 4 Gonzalez RP, Falimirski M, Holevar MR, Evankovich C. Surgical management of renal trauma: is vascular control necessary?. J Trauma 1999; 47 (06) 1039-1042 , discussion 1042–1044
    CrossrefPubMedSearch in Google Scholar
  • 5 Voelzke BB, Leddy L. The epidemiology of renal trauma. Transl Androl Urol 2014; 3 (02) 143-149
    PubMedSearch in Google Scholar
  • 6 Zealley IA, Chakraverty S. The role of interventional radiology in trauma. BMJ 2010; 340: c497
    CrossrefPubMedSearch in Google Scholar
  • 7 Hagiwara A, Sakaki S, Goto H. et al. The role of interventional radiology in the management of blunt renal injury: a practical protocol. J Trauma 2001; 51 (03) 526-531
    CrossrefPubMedSearch in Google Scholar
  • 8 Ierardi AM, Floridi C, Fontana F. et al. Transcatheter embolisation of iatrogenic renal vascular injuries. Radiol Med (Torino) 2014; 119 (04) 261-268
    CrossrefPubMedSearch in Google Scholar
  • 9 Schmidlin F, Farshad M, Bidaut L. et al. Biomechanical analysis and clinical treatment of blunt renal trauma. Swiss Surg 1998; 5 (05) 237-243
    PubMedSearch in Google Scholar
  • 10 Ramaswamy RS, Darcy MD. Arterial embolization for the treatment of renal masses and traumatic renal injuries. Tech Vasc Interv Radiol 2016; 19 (03) 203-210
    CrossrefPubMedSearch in Google Scholar
  • 11 Sampaio FJB, Passos MARF. Renal arteries: anatomic study for surgical and radiological practice. Surg Radiol Anat 1992; 14 (02) 113-117
    CrossrefPubMedSearch in Google Scholar
  • 12 Brewer Jr ME, Strnad BT, Daley BJ. et al. Percutaneous embolization for the management of grade 5 renal trauma in hemodynamically unstable patients: initial experience. J Urol 2009; 181 (04) 1737-1741
    CrossrefPubMedSearch in Google Scholar
  • 13 Matsumoto J, Lohman BD, Morimoto K, Ichinose Y, Hattori T, Taira Y. Damage control interventional radiology (DCIR) in prompt and rapid endovascular strategies in trauma occasions (PRESTO): a new paradigm. Diagn Interv Imaging 2015; 96 (7-8): 687-691
    CrossrefPubMedSearch in Google Scholar
  • 14 Mani NBS, Kim L. The role of interventional radiology in urologic tract trauma. Semin Intervent Radiol 2011; 28 (04) 415-423
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 Kozar RA, Crandall M, Shanmuganathan K. et al; AAST Patient Assessment Committee. Organ injury scaling 2018 update: spleen, liver, and kidney. J Trauma Acute Care Surg 2018; 85 (06) 1119-1122
    CrossrefPubMedSearch in Google Scholar
  • 16 Gould JE, Vedantham S. The role of interventional radiology in trauma. Semin Intervent Radiol 2006; 23 (03) 270-278
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Vignali C, Lonzi S, Bargellini I. et al. Vascular injuries after percutaneous renal procedures: treatment by transcatheter embolization. Eur Radiol 2004; 14 (04) 723-729
    CrossrefPubMedSearch in Google Scholar
  • 18 Fisher RG, Ben-Menachem Y, Whigham C. Stab wounds of the renal artery branches: angiographic diagnosis and treatment by embolization. AJR Am J Roentgenol 1989; 152 (06) 1231-1235
    CrossrefPubMedSearch in Google Scholar
  • 19 Uflacker R, Paolini RM, Lima S. Management of traumatic hematuria by selective renal artery embolization. J Urol 1984; 132 (04) 662-667
    CrossrefPubMedSearch in Google Scholar
  • 20 Lee RS, Porter JR. Traumatic renal artery pseudoaneurysm: diagnosis and management techniques. J Trauma 2003; 55 (05) 972-978
    CrossrefPubMedSearch in Google Scholar
  • 21 Markovic B, Markovic Z, Pejcic T. Embolization of insufficiently ligated renal artery after open nephrectomy with absolute ethanol injection. Diagn Interv Radiol 2011; 17 (01) 88-91
    PubMedSearch in Google Scholar
  • 22 Titton RL, Gervais DA, Boland GW, Mueller PR. Renal trauma: radiologic evaluation and percutaneous treatment of nonvascular injuries. AJR Am J Roentgenol 2002; 178 (06) 1507-1511
    CrossrefPubMedSearch in Google Scholar
  • 23 Breyer BN, McAninch JW, Elliott SP, Master VA. Minimally invasive endovascular techniques to treat acute renal hemorrhage. J Urol 2008; 179 (06) 2248-2252 , discussion 2253
    CrossrefPubMedSearch in Google Scholar
  • 24 Menaker J, Joseph B, Stein DM, Scalea TM. Angiointervention: high rates of failure following blunt renal injuries. World J Surg 2011; 35 (03) 520-527
    CrossrefPubMedSearch in Google Scholar
  • 25 Zeng G, Zhao Z, Wan S. et al. Failure of initial renal arterial embolization for severe post-percutaneous nephrolithotomy hemorrhage: a multicenter study of risk factors. J Urol 2013; 190 (06) 2133-2138
    CrossrefPubMedSearch in Google Scholar
  • 26 Page IH. The production of persistent arterial hypertension by cellophane perinephritis. J Am Med Assoc 1939; 113 (23) 2046-2048
    PubMedSearch in Google Scholar
  • 27 Colaco M, Navarrete RA, MacDonald SM, Stitzel JD, Terlecki RP. Nationwide procedural trends for renal trauma management. Ann Surg 2019; 269 (02) 367-369
    CrossrefPubMedSearch in Google Scholar