Effect of transarterial embolization of iatrogenic renal artery pseudoaneurysms without or with arteriovenous fistula on renal function at 6-month follow-up

Introduction

Transarterial embolization (TAE) is the gold standard treatment for iatrogenic renal artery pseudoaneurysms (PSA) and pseudoaneurysms with arteriovenous fistula (PSA + AVF), but its impact on renal function has not been sufficiently investigated. The aim of the study is to assess the impact on of TAE on renal function and its technical and clinical effectiveness.

Materials and methods

Sixty-seven embolization procedures in 61 consecutive patients from December 2006 to October 2020 in two centers were retrospectively reviewed for the following parameters: technical and clinical success and failure, embolization materials, type and dimensions of vascular injuries, percentage of post-procedural ischemic renal parenchyma and estimated glomerular filtration rate (eGFR) values before and 1 day after the surgical, percutaneous or endoscopic (SPE) procedure and before, 1 day after and 6 months after TAE.

Results

We identified 44 PSA and 23 PSA + AVF. Technical success was 95.5%, primary clinical success was 90.2% and secondary clinical success was 96.7%. Different embolization materials were used. A significant decrease of the eGFR was found after the SPE procedure. No significant difference was found between eGFR before and after TAE. A minimal significant improvement of the eGFR was found 6 months after TAE. Embolization of larger lesions resulted in larger post-procedural ischemic areas. PSA + AVF were significantly larger (p = 0.0142) and determined a larger post-procedural ischemic area. No correlation was found between dimensions, kind of vascular injury or post-procedural ischemic area and eGFR.

Conclusion

TAE has high technical and clinical success rates and does not affect renal function negatively, regardless of dimensions or kind of vascular injuries or post-procedural ischemic area.