Post-Traumatic Renal Artery Pseudoaneurysm Managed Successfully with Angioembolization

Abstract

Renal artery pseudoaneurysm is a rare complication of blunt renal trauma. Super-selective angioembolization is a
minimally invasive, effective procedure to manage traumatic renal artery pseudoaneurysm, in patients who are hemodynamically
stable. We report our experience in the management of patients with post-traumatic bleeding pseudoaneurysm with
angioembolization. Materials and methods: We retrospectively reviewed the inpatient and outpatient records and imaging
data of our hospital, of all patients with history of blunt injury to kidneys, admitted with massive hematuria and underwent
angioembolization to control the bleeding. Results: During the study period, 3 patients (all male) with a mean age of 26.66 years
presented to us with blunt injury abdomen. Contrast computed tomography (CT) revealed Grade IV renal injury in 2 patients
and Grade V injury in 1 patient. Focal intensively enhancing areas were noted at the site of renal parenchymal lacerations
suggestive of pseudoaneurysms. Super-selective catheterization was performed and embolization done using 50% N-butyl-2-
cyanoacrylate (NBCA) + Lipiodol. Conclusions: Angioembolization, a radiographic intervention, is an effective and minimally
invasive technique to stop active bleeding from renal artery pseudoaneurysms.