Efficacy and safety of renal artery embolization for blunt traumatic renal hemorrhage: a multicenter study.

Objective: To evaluate the efficacy and safety of renal artery embolization (RAE) for the management of blunt traumatic renal hemorrhage.

Methods: Patients with blunt traumatic renal hemorrhage treated with RAE across four hospitals from January 2018 to December 2024 were included in the study. Technical and clinical success rates, renal function preservation, side effects and complication were analyzed.

Results: In the 71 study patients, the technical success rate of RAE was 100%, and the clinical success rate was 93.0% (66/71). The mean RAE procedure time was 1.2 ± 0.5 h and which was increased with higher American Association for the Surgery of Trauma (AAST) grades, and significantly longer was required for higher AAST grade. The mean infarcted renal area was 38% (range, 15-80%). The average serum creatinine level pre- and 1, 3, 5 and 7 days post-RAE were 95.6 ± 47.1 µmol/L, 99.0 ± 44.3 µmol/L, 88.4 ± 31.7 µmol/L, 85.0 ± 27.5 µmol/L and 78.5 ± 41.1 µmol/L, respectively. Different embolic materials (coils vs. gelatin sponge particles) showed no significant differences in technical and clinical success rates but highlighted cost advantages for gelatin sponge particles (4003.4 ± 1381.9 vs. 1919.4 ± 345.7 CNY; P < 0.001). The most common side effect was fever (42.3%), while no RAE related major complications.

Conclusion: RAE is a highly effective and minimally invasive treatment for blunt traumatic renal hemorrhage, with significant success in hemostasis and renal function preservation. Gelatin sponge particles should be used as first line choice for RAE.