Akut Renal Arter Kanamalarında Endovasküler Tedavi: Etkinliği ve Böbrek Fonksiyonlarına Etkisi

Amaç: Bu çalışmanın amacı akut renal arter kaynaklı hemorajilerin endovasküler tedavisinin etkinliğini ve komplikasyonlarını ile kanamaya neden olan etiyolojiyi araştırmaktır. Gereç ve Yöntemler: 2016 ve 2020 yılları arasında akut renal arter kanaması nedeni ile endovasküler embolizasyon yapılan yirmi iki hasta geriye dönük olarak değerlendirildi. Akut renal arter hemorajisinin etiyolojisi araştırıldı. Tedavinin etkinliği ve gelişen komplikasyonlar için laboratuvar ve klinik takip bilgileri analiz edildi. Hastaların işlem öncesi ve işlem sonrası serum kreatinin düzeyleri karşılaştırıldı. Bulgular: Toplam 22 hastaya selektif renal arter embolizasyonu işlemi uygulandı. Bu 22 hastanın 10 (%45,5) tanesi erkek ve 12 (%54,5) tanesi kadın idi. Hastaların yaşları 5 ile 79 yıl arasında değişmekteydi ve hastaların ortalama yaşı 51,5±18,6 yıl olarak saptandı. Embolizasyon işlemlerinin %91,7’sinde klinik başarı sağlandı. Hastaların işlem sonrasındaki serum kreatinin düzeylerinde, anjiyografi işleminden 24 saat öncesine göre istatistiksel olarak anlamlı bir artış görüldü (ortanca: 0,97’ye karşı 0,93; p=0,046). Serum kan üre nitrojeni ve tahmini glomerüler filtrasyon hızı düzeylerinde anlamlı bir değişiklik gözlenmedi (sırasıyla p=0,338 ve p=0,067). Komplikasyon olarak sadece bir hastada akut böbrek yetmezliği ve postembolizasyon sendromu izlendi. Komplikasyon oranı %4,5 olarak bulundu. Sonuç: Akut renal arter kanamalarında renal arterin selektif embolizasyonu renal fonksiyonlarda bozulmaya neden olmadan yüksek bir klinik başarıya sahiptir. Tedavinin genel anesteziye gerek olmaması ve düşük komplikasyon oranları gibi avantajları vardır.

Anahtar Kelimeler:

Embolizasyon, kanama, endovasküler, renal anjiyografi, renal arter

Endovascular Treatment of Acute Renal Artery Hemorrhages: Efficacy and Effect on Renal Functions

Aim: The aim of this study was to investigate the efficacy and complications of endovascular treatment of acute renal artery hemorrhage and the etiology of the condition. Material and Methods: Twenty-two patients who underwent endovascular embolization with renal acute artery hemorrhage between 2016 and 2020 were evaluated retrospectively. Etiologies of the acute renal artery hemorrhage were investigated. Laboratory and clinical follow-up information were analyzed for the efficacy and the complication of the treatment. The serum creatinine levels of the patients before and after the procedure were compared. Results: Selective renal artery embolization procedures were performed in a total of 22 patients. Of the 22 patients, 10 (45.5%) were male and 12 (54.5%) were female. The patients' ages ranged from 5 to 79 years, and the mean age of the patients was 51.5±18.6 years. Clinical success was achieved in 91.7% of embolization procedures. A statistically significant increase was seen in the serum creatinine levels of the patients after the procedure compared to 24 hours before the angiography procedure (median: 0.97 vs. 0.93, p=0.046). No significant change was observed in serum blood urea nitrogen and the estimated glomerular filtration rate levels (p=0.338, and p=0.067, respectively). Acute renal failure and postembolization syndrome were observed in only one patient as complications. The complication rate was found to be 4.5%. Conclusion: Selective embolization of the renal artery has high clinical success in acute renal artery hemorrhages without impairing renal function. The treatment has advantages such as no need for general anesthesia, and low complication rates.

Keywords:

Ebolisation, Bleeding, endovascular, renal angiography, renal artery,

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