Post-Traumatic Renal Artery Pseudoaneurysm Managed Successfully with Angioembolization

Dr KEYUR PATEL; Dr RAJENDRA B NERLI; Dr NAVIN MULIMANI; Dr  SHREYAS RAI; Dr ABHINAY JOGULA; Dr ASHWIN BOKARE; Dr NISHANT SETYA

doi:10.59793/ijcp.v34i9.776

Authors

Dr KEYUR PATEL Senior Resident
Dr RAJENDRA B NERLI Professor and Head Dept. of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Nehru Nagar, Belagavi, Karnataka - 590010, India
Dr NAVIN MULIMANI Dept. of Urology
Dr SHREYAS RAI Associate Professor, Dept. of Interventional Radiology
Dr ABHINAY JOGULA senior consultant
Dr ASHWIN BOKARE Resident, Dept. of Urology
Dr NISHANT SETYA

DOI:

https://doi.org/10.59793/ijcp.v34i9.776

Keywords:

Delayed hematuria,, blunt renal trauma,, minimally invasive technique

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.