EMBOLIZATION FOR THE TREATMENT OF DELAYED HEMATURIA RENAL ARTERY PSEUDOANEURYSM FOLLOWING BLUNT TRAUMA

Ginanda Nabilla Hardiyanti, Ahmad Khairulnaim Bin Ahmad Kabir, Nur Liyana Mohamed Mustafa, Anas Tharek, Mohd Fandi Al-Khafiz Kamis, Achmad Bayhaqi Nasir Aslam, Ahmad Sobri Bin Muda
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 Objective: The objective of this study is to provide a detailed account of the use of an angiographic catheter and embolization in the treatment of a patient afflicted with a post-traumatic renal artery pseudoaneurysm.
 Materials and Methods: Conducting a literature review and medical records.
 Results: A case of renal artery pseudoaneurysm is presented. A male individual aged 33 sought medical attention at the emergency department following a motorcycle collision and exhibited symptoms of pain in the right flank region. The individual underwent a medical intervention involving the placement of a double J stent. After a period of nearly fourteen days, the individual reported experiencing hematuria. The abdominal CT scan revealed a renal injury on the right side with an AAST grade of 4, while the renal CTA demonstrated the presence of a pseudoaneurysm. A pseudoaneurysm was observed at the renal poles on the right side through the use of an angiographic catheter. The procedure of selective embolization utilising coils was executed on the renal arteries located at the lower and middle poles of the right kidney.
 Conclusion: The occurrence of renal artery pseudoaneurysms is infrequent; however, it is a grave complication that may arise from renal trauma. The accurate diagnosis and effective management of pseudoaneurysms are of paramount importance due to their potential to cause severe and potentially fatal complications if left untreated. The diagnostic process for pseudoaneurysms heavily relies on the involvement of the general radiologist. Interventional radiology provides alternative minimally invasive procedures that are linked to reduced morbidity and mortality rates and have replaced surgical interventions in the management of certain conditions.
 Keywords: pseudoaneurysm, angiographic catheter, embolization","PeriodicalId":489725,"journal":{"name":"The Interventionalist Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Interventionalist Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.32896/tij.v3n3.1-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract

Background: The occurrence of a renal artery pseudoaneurysm after blunt renal trauma is an infrequent complication. The occurrence of delayed bleeding is typically observed within a period of 2 to 3 weeks following an injury and is commonly attributed to the presence of an arteriovenous malformation (AVM) or pseudoaneurysm. They are frequently observed in cases of injuries of greater severity or trauma that penetrates the body. The application of angiographic catheterization is efficacious in the detection of pseudoaneurysms in the renal artery. The management of renal pseudoaneurysms necessitates the consideration of distinct clinical associations, including the location and size of the lesion as well as the presence of symptoms. Objective: The objective of this study is to provide a detailed account of the use of an angiographic catheter and embolization in the treatment of a patient afflicted with a post-traumatic renal artery pseudoaneurysm. Materials and Methods: Conducting a literature review and medical records. Results: A case of renal artery pseudoaneurysm is presented. A male individual aged 33 sought medical attention at the emergency department following a motorcycle collision and exhibited symptoms of pain in the right flank region. The individual underwent a medical intervention involving the placement of a double J stent. After a period of nearly fourteen days, the individual reported experiencing hematuria. The abdominal CT scan revealed a renal injury on the right side with an AAST grade of 4, while the renal CTA demonstrated the presence of a pseudoaneurysm. A pseudoaneurysm was observed at the renal poles on the right side through the use of an angiographic catheter. The procedure of selective embolization utilising coils was executed on the renal arteries located at the lower and middle poles of the right kidney. Conclusion: The occurrence of renal artery pseudoaneurysms is infrequent; however, it is a grave complication that may arise from renal trauma. The accurate diagnosis and effective management of pseudoaneurysms are of paramount importance due to their potential to cause severe and potentially fatal complications if left untreated. The diagnostic process for pseudoaneurysms heavily relies on the involvement of the general radiologist. Interventional radiology provides alternative minimally invasive procedures that are linked to reduced morbidity and mortality rates and have replaced surgical interventions in the management of certain conditions. Keywords: pseudoaneurysm, angiographic catheter, embolization
栓塞治疗钝性创伤后迟发性血尿肾动脉假性动脉瘤
背景:钝性肾外伤后发生肾动脉假性动脉瘤是一种罕见的并发症。迟发性出血通常发生在损伤后的2至3周内,通常归因于动静脉畸形(AVM)或假性动脉瘤的存在。它们经常出现在更严重的伤害或穿透身体的创伤的情况下。血管造影置管对肾动脉假性动脉瘤的检测是有效的。肾假性动脉瘤的治疗需要考虑不同的临床关联,包括病变的位置和大小以及症状的存在。 目的:本研究的目的是提供血管造影导管和栓塞治疗创伤后肾动脉假性动脉瘤患者的详细说明。材料和方法:进行文献综述和医疗记录。 结果:报告1例肾动脉假性动脉瘤。一名33岁男性在摩托车碰撞后到急诊科求医,表现出右侧区域疼痛的症状。该患者接受了包括放置双J型支架在内的医疗干预。近14天后,患者报告出现血尿。腹部CT扫描显示右侧肾损伤,AAST分级为4级,肾CTA显示存在假性动脉瘤。通过使用血管造影导管在右侧肾极观察到假性动脉瘤。对右肾下、中极肾动脉行线圈选择性栓塞术。 结论:肾动脉假性动脉瘤发生率较低;然而,这是一种严重的并发症,可能引起肾外伤。假性动脉瘤的准确诊断和有效治疗至关重要,因为如果不及时治疗,假性动脉瘤可能会导致严重和潜在的致命并发症。假性动脉瘤的诊断过程在很大程度上依赖于普通放射科医生的参与。介入放射学提供了与降低发病率和死亡率相关的替代微创手术,并在某些情况下取代了手术干预。 关键词:假性动脉瘤,血管造影导管,栓塞
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