Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.200005
Jornal Vascular Brasileiro
Therapeutic Challenge

Superselective renal artery embolization for treatment of urological hemorrhage after partial nephrectomy in a solitary kidney

Embolização superseletiva da artéria renal para o tratamento de hemorragia urológica após nefrectomia parcial em rim único

José Maciel Caldas dos Reis; Fábio Akimaro Kudo; Moisés do Carmo Bastos; Humberto Balbi Reale Neto; Maurício Figueiredo Massulo Aguiar; José Victor Figueiredo dos Santos

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Abstract

Abstract: Embolization is a well-known and accepted form of treatment for bleeding caused by a multitude of renal procedures. We present a case of a 66-year-old woman who had a history of left nephrectomy for clear cell carcinoma seven years previously and now presented with a 6 cm tumor involving the solitary kidney. She underwent partial laparoscopic nephrectomy with removal of the tumor on the right kidney. In the immediate postoperative period she had important and persistent hematuria associated with tachycardia, hypotension, and lumbar pain. After showing signs of hemodynamic instability, she was taken to the catheter laboratory where selective angiography of the right kidney was performed. Superselective embolization with controlled release of fibrous microcoils was performed. The superselective renal embolization technique performed on an emergency basis to control hemorrhage after a urological procedure is effective and achieves lasting resolution of symptoms.

Keywords

kidney, renal hemorrhage, kidney angiography, therapeutic embolization

Resumo

Resumo: A embolização é uma forma bem conhecida e aceita de tratamento para sangramento de inúmeros procedimentos renais. Apresentamos o caso de uma mulher de 66 anos de idade com história de nefrectomia esquerda por carcinoma de células claras havia 7 anos, que desta vez apresentava rim único afetado por um tumor de 6 cm. Ela foi submetida a nefrectomia parcial videolaparoscópica com remoção do tumor no rim direito. Apresentou, no pós-operatório imediato, hematúria importante e persistente associada a taquicardia, hipotensão e dor lombar. A paciente apresentou sinais de instabilidade hemodinâmica e foi levada ao setor de hemodinâmica, onde foi realizada angiografia seletiva do rim direito. Foi localizado foco sangrante, sendo então realizada embolização superseletiva com liberação controlada de microcomolas. A técnica de embolização renal superseletiva realizada em caráter de emergência para controlar a hemorragia após um procedimento urológico é uma solução eficaz, minimamente invasiva e segura para controle dos sintomas.
 

Palavras-chave

rim, hemorragia renal, angiografia renal, embolização terapêutica

References

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Submitted date:
04/08/2020

Accepted date:
06/03/2020

5f91829b0e88256b181ddb39 jvb Articles
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