• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.211-214
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• 2001

The embolic effect of Gelfoam was investigated for transarterial embolization of renal artery (TAE-RA) in four normal rabbits. The catheter was selectively introduced into the unilateral renal artery under fluoroscopy and the Gelfoam-iohexol mixture was infused through a catheter into the renal arteries of 4 rabbits. The immediate and delayed (8 weeks) embolic effects on the renal arteries was investigated with selective angiography. The Gelfoam-iohexol was visualized under fluorosxopy in four rabbits. Renal arteries were ablated immediately after TAE-RA in four rabbits, however, opacification of renal parenchyma was visualized by injected contrast agent in 3 rabbits at 8 weeks. The Gelfoam-iohexol can be used as a short-term embolic materials for TAE-RA, however it is not adequate for permanent embolization of renal artery.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.212-215
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• 2005

Renal artery stenosis is a major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. There are several methods to treat renal artery stenosis, including surgery, percutaneous transluminal renal angioplasty(PTRA), and renal artery stenting(RAS). But, renal artery embolization can be tried in atherosclerotic stenosis, multiple stenosis, microaneurysm, and stenosis difficult to try PTRA or RAS. We report a case of renovascular hypertension in a 14-year-old female who had multiple segmental renal artery stenosis. Hypertension was controlled by renal ablation therapy with renal artery embolization.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.198-202
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• 2021

Super-selective renal artery embolization is an increasingly popular technique for the management of traumatic, low-grade renal trauma. When performed in distal arterial branches, this intervention enables tissue preservation and arrest of hemorrhage, but it may not be practical in cases of multifocal, high-grade renal injuries. In such cases, surgical nephrectomy remains the more common treatment modality to ensure hemodynamic control. We present the unique case of a patient who presented in hemorrhagic shock following a major trauma that resulted in a grade 5 renal injury treated with complete renal artery embolization using Gelfoam, resulting in hemodynamic stabilization. Interestingly, imaging 1 month after embolization revealed residual enhancement of the inferior pole of the kidney, suggesting reconstitution of flow and partial renal salvage. Ultimately, transcatheter "nephrectomy" with careful selection of a temporary embolic agent may serve as a safe and efficient alternative to surgical nephrectomy with the added possibility of preserving partial renal perfusion and function in the emergent setting.

• Korean Journal of Radiology
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• v.1 no.3
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• pp.121-126
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• 2000

Objective: To evaluate the therapeutic efficacy of a new liquid embolic material, Embol, in embolization of the renal artery. Materials and Methods: Embol is a new embolic material obtained by partial hydrolysis of polyvinyl acetate mixed in absolute ethanol and Iopromide 370 and manufactured by Schering Korea, Kyonggido, Korea. Six patients who underwent embolization of the renal artery using Embol were evaluated. Four were male and two were female and their ages ranged from 11 to 70 (mean, 53) years. Clinical and radiologic diagnoses referred for renal artery embolization were renal cell carcinoma (n = 3), renal angiomyolipoma (n = 2) and pseudoaneurysm of the renal artery (n = 1). After selective renal angiography, Embol was injected through various catheters, either with or without a balloon occlusion catheter. Changes in symptoms and blood chemistry which may have been related to renal artery embolization with Embol were analyzed. Results: The six patients showed immediate total occlusion of their renal vascular lesions. One of the three in whom renal cell carcinoma was embolized with Embol underwent radical nephrectomy, and the specimen thus obtained revealed 40% tumor necrosis. In the two patients with angiomyolipomas, the tumors decreased in size and abdominal pain subsided. Bleeding from pseudoaneurysm of the renal artery was successfully controlled. Four patients showed symptoms of post-embolization syndrome, and one of these also showed increased levels of blood urea nitrogen and creatinine. One patient experienced transient hypertension. Conclusion: Embol is easy to use, its radiopacity is adequate and it is a safe and effective embolic material which provides immediate and total occlusion of renal vascular lesions.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.260-263
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• 2009

Renal artery pseudoaneurysm after blunt renal trauma is an uncommon complication of delayed hemorrhage, and diagnostic difficulties are experienced due to its rarity. Delayed hemorrhage after renal trauma is a life-threatening complication. Angiography is considered the gold standard to diagnose a traumatic renal artery pseudoaneurysm. We report here a case of delayed bleeding from a renal artery pseudoaneurysm that was diagnosed at 17 days after the injury and that was managed successfully with selective renal artery embolization without medical complication.

• Journal of Veterinary Clinics
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• v.22 no.2
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• pp.119-124
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• 2005

This study was performed to validate the procedure of transarterial embolization of the renal artery (TAE-RA) and sclerotherapy of renal pelvis using iohexol-ethanol solution in dogs with unilateral experimental hydronephrosis. Experimental hydronephrosis was induced by unilateral ureter ligation for 20 days in five Beagle dogs. Renal artery embolization with iohexol-ethanol solution was performed using selective catheterization technique in the hydronephrotic kidney and sclerotherapy was done by injection of the iohexol-ethanol solution through percutaneously placed pig-tail catheter. EKG, $SpO_2$ body temperature, pulse, and respiratory rate were within normal ranges during procedures. Average pure ethanol dose for renal artery embolization was $1.1\pm0.3ml/kg$. Renal artery embolization was confirmed by the detection of no blood flow signal at the interlobar and arcuate artery using color Doppler ultrasonography. There were no dogs expired after TAE-RA and sclerotherapy and no side effects associated with regurgitation of iohexol-ethanol solution. The value of BUN, creatinine, ALT, AST, Ca, P in five dogs were within normal range during the experiment period. Ultrasonographically, the mean longitudinal and transverse length and the depth of the embolized kidney significantly decreased at 28 days after TAE-RA. We may conclude that TAE-RA and sclerotherapy with iohexol-ethanol solution is an effective methods for the treatment of unilateral hydronephrosis in dogs.

• Journal of Trauma and Injury
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• v.23 no.1
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• pp.16-20
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• 2010

Purpose: High-grade (III, IV, V) renal injury may need interventional management. We investigated whether the selective embolization of the renal artery is effective for the treatment of major renal injury in comparison with emergency renal exploration. Methods: We retrospectively reviewed the medical and radiologic records of patients who underwent surgery or embolization for renal injury (Grade III, IV, V) between January 1990 and December 2007. We analyzed the change in treatment method before and after 2000, the blood pressure, the hemoglobin at the time of visit, the hospital days and the complications in patients who received surgery or embolization. Preserved renal functions of the embolized kidneys were identified by using enhanced CT. Results: Cases of surgery and embolization were 37 and 13, respectively: 5 and 4 in renal injury grade III, 17 and 6 in grade IV and 13 and 3 in grade V. Cases of surgery and embolization were 33 and 1 before 2000 and 2 and 12 after 2000, repectively: embolizations increased after 2000. No significant differences in mean diastolic pressure, hemoglobin, hospital days and complications existed between the surgery and the embolization groups (p>0.05). However, the transfusion volume was significantly smaller in the embolization group (p<0.05). One postoperative complication occurred in the surgery group. We identified the preserved renal functions of the embolized kidney by using enhanced CT. Conclusion: Embolization could be one treatment method for high-grade renal injury. Thus, we might suggest selective embolization a useful method for preserving the renal function in cases of high-grade renal injury.

• Korean Journal of Veterinary Research
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• v.41 no.3
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• pp.413-419
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• 2001

This study was performed to evaluate the renal hemodynamics using color Doppler ultrasonography in dogs with unilateral experimental hydronephrosis treated with transarterial embolization of the renal artery (TAE-RA). Experimental hydronephrosis was induced by ligation of unilateral ureter in 12 dogs. The mean resistive index (RI) value of kidney was significantly increased at 4, 9, 17 days after ligation of ureter. Unilateral hydronephrosis was established in 12 dogs at 17 days after ligation of ureter. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$body temperature, pulse, and respiratory rate were within normal ranges during procedures. There were no dogs expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. In color Doppler ultrasonographic findings, there was no blood flow into the embolized kidneys treated by TAE-RA, however, blood flow signal was found in contralateral normal kidney of dogs treated with TAE-RA compared to that of normal kidney in normal control group. It is concluded that TAE-RA does not affect the hemodynamics of contralateral normal kidney in dogs with experimental hydronephrosis and color Doppler ultrasonography is simple and non-invasive modality for the monitoring of the revascularization of the renal artery after TAE-RA.

• Journal of Yeungnam Medical Science
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• v.12 no.1
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• pp.96-104
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• 1995

The transarterial embolization has been widely used to control bleeding. It has a variety of clinical utility; to reduce bleeding on the surgical field, to reduce the size of malignant tumor as a preopearative treatment, to treat arteriovenous malformation or arterial aneurysm as a curative method and to promote life quality of patient with diffuse or multiple hepatocellular carcinoma as a palliative treatment, etc. With the advance of modem technology, various embolic materials have been also developed. However, it has not been fully investigated of histopathologic changes of the embolized organs according to the embolic materials used. This study was undertaken to investigate the histopathologic changes of embolized renal artery in rabbit by various embolic materials, according to each embolic material and to time passed by after embolization. Of the 5 arteries embolized by ethylene vinyl alcohol copolymer(EVAL), one showed abscess formation in embolized kidney. The other 4 allowed to perform further pathologic study: within a week after embolization there was no any specific change in vessels, however, minimal endothelial hypertrophy was observed following 2 weeks of embolization. Of the 8 renal arteries embolized by N-buthyl-2-cyanoacrylate(Histoacryl), 4 showed total occlusion of the main renal arteries as well as renal infarction, which reflects the strong adhesiveness of Histoacryl to vascular wall. The other 4 showed fibrinoid degeneration in vascular wall within a week. However, further change was not observed thereafter. In all the 5 renal arteries embolized by polyvinyl alcohol(Ivalon), there were infiltration of inflammatory cells along the vessel walls, within one week, which represents vasculitis. They showed some fibrosis with appearance of giant cells in the vessel wall two weeks after embolization and also showed marked fibrosis of connective tissues surrounding vessels two months after embolization, respectively. The results suggest that EVAL is useful for the embolization of hypervascular lesion with limited arteriovenous fistula, Histoacryl for the curative treatment of the lesion with high blood flow or severe arteriovenous fistula, and Ivalan for palliative treatment of malignant tumor or arteriovenous malformation, respectively.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1595-1598
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• 2012

The aim of this study was to explore the angiographic diagnosis and embolization therapy for renal artery pseudoaneurysms due to acute urinary tract hemorrhage after conservative medical management failed. Seven out of ten cases had fever symptoms after the kidney surgery. The pseudoaneurysms were treated with gelatin sponge and (or) spring coil and the majority demonstrated rapid blockage of hemorrhage. Angiography diagnosis and trans catheter embolization are rapid, safe and effective methods for diagnosis and treatment of renal artery pseudoaneurysms.