EVALUATION OF ANGIOGRAPHIC EMBOLIZATION OUTCOMES IN THE TREATMENT OF RENAL TRAUMA WITH ARTERIAL INJURY

SY THAN VAN1, , Đức Hùng Dương2,3,4, Thanh Dũng Lê5,6,7, Quang Lộc Trần7,8, Ngọc Linh Phạm7, Đức Thắng Hoàng7
1 Department of Radiology, Viet Duc Umiversity Hospital
2 Viet Duc University Hospital
3 Hanoi Medical University
4 University of Medicine and Pharmacy (VNU-UMP), Vietnam National University
5 Bệnh viện Hữu nghị việt Đức
6 Trường Đại học Y Hà Nội
7 Trường Đại học Y Dược - Đại học Quốc Gia Hà Nội
8 Bệnh viện Hữu nghị Việt Đức

Main Article Content

Abstract

Objective: This study aims to analyze the clinical, laboratory, and imaging characteristics of patients with renal trauma who underwent endovascular embolization. Additionally, it evaluates the outcomes of embolization in the management of renal trauma.


Materials and Methods: A cross-sectional descriptive study was conducted on 77 patients with renal trauma who underwent embolization at Viet Duc Hospital from January 2021 to January 2025.


Results: Flank and lumbar pain were the most common symptoms, occurring in 84.5% of cases. Upon hospital admission, 81% of patients were hemodynamically stable. According to the 2019 World Society of Emergency Surgery (WSES) classification, 17 (22.1%) cases were classified as grade II, 46 (69.4%) as grade III, and 14 (18.2%) as grade IV. Among the 36 patients requiring blood transfusion before intervention, the mean transfused volume was 3.2 ± 2.9 units. The technical success rate after the first embolization attempt was 96.1%, while the clinical success rate was 89.6%. Two patients (2.6%) required repeat embolization, and six patients (7.8%) underwent nephrectomy after embolization. The average hospital stay was 13.7 ± 10.6 days. Common minor complications included post-embolization fever (1.3%) and hematuria (7.8%). One patient (1.3%) died.


Conclusion: Angiographic embolization is a safe and effective treatment for renal trauma, achieving high success rates in renal trauma conservation. The 2019 WSES classification system aids in guiding treatment strategies.

Article Details

References

1. Anh P. N, Thiện D. Đ, Hùng N. D, và Dũng L. T, “Hiệu quả điều trị can thiệp nội mạch tổn thương động mạch thận do chấn thương”, Tạp Chí Điện Quang Học Hạt Nhân Việt Nam, số p.h 15, Art. số p.h 15, tháng 7 2022.
2. T. Ząbkowski, R. Skiba, M. Saracen, và H. Zieliński, “Analysis of Renal Trauma in Adult Patients: A 6-Year Own Experiences of Trauma Center”, Urol. J, vol 12 (4), 2276–2279, September 2015.
3. T. A. Smith, A. Eastaway, D. Hartt, và K. B. Quencer, “Endovascular embolization in renal trauma: a narrative review”, Ann. Translate. Med, vol 9(14), 1198, July 2021.
4. F. Coccolini và c.s., “Kidney and uro-trauma: WSES-AAST guidelines”, World J. Emerg. Surg, vol 14(1), 54,December 2019.
5. T. Sugihara và c.s., “Management trends, angioembolization performance and multiorgan injury indicators of renal trauma from Japanese administrative claims database”, Int. J. Urol, vol 19(6), 559–563, 2012.
6. X. Shen và c.s., “The application of deep learning in abdominal trauma diagnosis by CT imaging”, World J. Emerg. Surg, vol 19(1), 17, May 2024.
7. S. P. McCombie và c.s., “The conservative management of renal trauma: a literature review and practical clinical guideline from Australia and New Zealand”, BJU Int, vol 114(S1),13–21, 2014.
8. J. E. Lopera, “Embolization in Trauma: Review of Basic Principles and Techniques”, Semin. Interv. Radiol, vol 38, 18–33, April 2021.
9. M. S. Alwarraky, M. M. Abdallah, và M. S. Elgharbawy, “Clinical outcome and safety of selective renal artery embolization using permanent occlusive agents for acute renal bleeding”, Egypt. J. Radiol. Nucl. Med, vol 51(1),p205, October 2020.
10. Liguori và c.s., “The role of angioembolization in the management of blunt renal injuries: a systematic review”, BMC Urol, vol 21(1), 104, August 2021.