Clinical factors that influence the occurrence of symptomatic pseudoaneurysms and arteriovenous fistulas after partial nephrectomy: multi-institutional study of renal function outcomes after one year of selective arterial embolization
Int. braz. j. urol
;
47(1): 149-158, Jan.-Feb. 2021. tab, graf
Article
in English
| LILACS
| ID: biblio-1134310
ABSTRACT
ABSTRACT Purpose:
Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function. Materials andMethods:
Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated.Results:
Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p <0.05). In the multivariate analysis, higher N component scores were associated with the occurrence of RAPs/AVFs (Odds ratio 1.96, p=0.039). In the SAE group, the mean 3-day postembolization eGFR was significantly lower than the mean 3-day postoperative eGFR (p <0.01). This difference in the eGFRs was still present 1 year later.Conclusions:
Renal tumors located near the renal sinus and collecting system were associated with a higher risk for RAPs/AVFs after PN. Although SAE was an effective method for controlling symptomatic RAPs/AVFs after PN, a procedure-related impairment of renal function after SAE could occur and still be present at the end of the first postoperative year.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Arteriovenous Fistula
/
Aneurysm, False
/
Kidney Neoplasms
Type of study:
Diagnostic study
/
Observational study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2021
Type:
Article
Affiliation country:
South Korea
Institution/Affiliation country:
Inje University College of Medicine/KR
/
Kyungpook National University/KR
/
Pusan National University School of Medicine/KR
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