An experimental study on vascular changes in renal biopsy injury

ABSTRACT

An experimental study on the vascular alternations of the kidney following biopsy procedure was carried out in 47 kidneys from 28 rabbits to clarify their nature and frequency by renal arteriography and microangiography together with histopathologic investigation. Renal arteriography and microangiography were perforemd immediately 2 days, 1 week, and 2 weeks after percutaneous biopsy and the findings were correlated with histological nature. The results are summerized as follows; 1. Important biopsy injuries verified by renal arteriography and microangiography were arterial spasm, perfusion defect, arteriovenous fistula, injury to vasa recta and renaltubules, intrarenal and extrarenal extravasation of contrast media, and arterial obstruction, in order of frequency. 2. Artierial spasm observed in majority of the cases were relieved during the period of 2 weeks. 3. Detectability of perfusion defect was 57% and 72% by angiography and microangiography, respectively, and this perfusion defect seemed to be mostly caused by renal infarction due to vascular injury, such as arteriovenousfistula, arterial obstruction and other vascular injuries. 4. Arteriovenous fistula was detected in 28% byangiography and 50% by microangiography. Many of the arteriovenous fistula appeared to be closed spontaneously within a week. Above findings suggest that renal biopsy procedure results in various degree of vascular injuries with their sequential modification, and that microangiography is assumed the most effective approach in analysisof biopsy injuries such as small arteriovenous fistula, perfusion defect, injury to vasa recta and renal tubules, overcoming the limitation of traditional angiography.