الفهرس | Only 14 pages are availabe for public view |
Abstract Renal vascular lesions may result from interventional urologic procedures such as percutaneous biopsy, nephrostomy and lithotripsy. Non-iatrogenic renal injury is usually associated with blunt trauma, stab wounds and gunshots. In the vast majority of patients, renal injuries are minor, self-limiting and need conservative treatment. However, in the presence of massive haemorrhage or continuous haematuria, urgent therapy may become necessary. Accepted indications for surgery are avulsion of the renal pelvis, injuries to the vascular pedicle and life-threatening hemodynamic instability. Surgical treatment for arteriovenous fistula is either partial or total nephrectomy or arterial ligation, resulting in gross renal parenchymal tissue loss. So, surgical intervention is performed in few percent of renal injuries and continues to decline in frequency with increasing the availability of minimally invasive techniques. Vascular injuries can be effectively treated with angiographic procedures. Superselective renal embolization has reported to be effective in the treatment of iatrogenic and penetrating vascular renal injuries. High success rate, low incidence of complications, and rapid recovery represent highly appealing reasons for making trans-catheter renal artery embolization in traumatized patients the first choice treatment option in cases of severe renal haemorrhage. |