Clinical Application Of Renal Artery CTA And Renal Artery Embolization In Acute Renal Hemorrhage

Subjective: To explore the clinical value of renal artery CTA in the preoperation of interventional embolization for acute renal hemorrhage,and to explore the different manifestations of acute renal hemorrhage and the methodology and effectiveness of endovascular embolization.Methods: During the period from February 2010 to October 2017,44 cases of patients with acute renal hemorrhage was collected at interventional radiology department in our hospital,acute renal hemorrhage standard for short-term renal bleeding or persistent hematuria than 72 h,renal stoma bleeding,hemoglobin,blood pressure decreased.All patients chose interventional therapy with endovascular embolization,and 34 cases of them underwent CTA examination of the renal artery with 320 CT before superselective renal artery embolization.Results:(1)34 cases of patients with bleeding were confirmed by DSA angiography hemorrhage,through renal artery CTA diagnosed 30 cases,there were found 8 cases of exudative hemorrhage(8/11),18 cases of pseudoaneurysm(18/18),2 cases of AVM(2/3),1 case of AVF(1/1),1 case of tumor vasculature(1/1);and there were found 32 of bleeding blood vessels,included 19 of segmental arteries,19 of segmental arteries(19/19),9 of interlobar arteries(9/12),5 of arteriae arciformes arteries and little interlobar arteries(5/11).(2)44 patients were treated with DSA angiography and superselective renal artery embolization.DSA angiography was performed in 42 cases to determine the hemorrhage focus.Among them,14 cases were exudative hemorrhage,19 cases were pseudoaneurysm,3 cases were arteriovenous malformation(AVM),1 cases were arteriovenous fistula(AVF),and 5 cases were tumor vessels.Liquid lipiolol,gelatin sponge,metal coils,PVA granules and Glubran? were used to embolize 2 patients with DSA.All patients were successfully hemostasis at one time.Conclusions:(1)CTA of renal artery has good detection rate for acute renal hemorrhage,and can fully display the renal vascular contorts,provide good preoperative guidance for interventional therapy?So it has wide clinical application value,and should be as a routine examination in acute renal hemorrhage intervention before renal artery embolization..(2)Superselective renal artery embolization is a safe and effective method for the treatment of acute renal hemorrhage.According to the etiology and angiographic manifestation,the key to successful embolization is to select reasonable embolization materials and embolization methods.(3)Patients with hemorrhage after PCNL,if CTA of renal artery and DSA angiography found no abnormalities,can use gelatin sponge to embolia the blood of puncture regional for a diagnosis.