Embolization in traumatic intrarenal vascular injuries

A retrospective study was made of 42 patients who had traumatic intrarenal false aneurysms or arteriovenous fistulae. Forty of these patients were treated by embolization. The majority of patients had renal stab wounds (23), while the other main causes were blunt injury (9), and iatrogenic injury following renal biopsy (7). Forty patients presented with persistent or recurrent haematuria and two with high output cardiac failure due to large arteriovenous fistulae. Embolization was performed using gelfoam and coils and was successful in 35 (87.5%) with complete resolution of haematuria. Re-embolization in the remaining five patients proved successful in four cases and a failure in only one. Complications included renal intimal dissection in three, ectopic coil placement and contrast extravasation each involving three patients while post-embolization pyrexia occurred in one patient. No patients developed hypertension after the procedure. Embolization was shown to provide a safe and effective form of treatment of intra-renal vascular injuries.