SELECTIVE EMBOLIZATION OF ACTIVE BLEEDING AFTER RENAL CANCER BIOPSY

  • Carlos Veterano Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Paulo Almeida Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Inês Antunes Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Carlos Veiga Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Duarte Rego Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Vítor Ferreira Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • João Gonçalves Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Gabriela Teixeira Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Daniel Mendes Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Pedro Sá Pinto Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
  • Rui Almeida Serviço de Angiologia e Cirurgia Vascular do Centro Hospitalar do Porto, Porto, Portugal
Keywords: Embolization, haemorrhage, renal biopsy, microparticles, angiography

Abstract

Major haemorrhage is a known complication of renal percutaneous biopsy, with a prevalence of 2.2%.  Selective arterial embolization is a safe, effective and minimal invasive procedure, having an important role in the management of active bleeding, for instance in iatrogenic lesions after renal biopsy.

Case report of a 52-year-old woman. Imagiological diagnosis of metastasized renal cancer and therefore submitted to percutaneous renal biopsy. Admitted in the emergency room with haemorrhagic shock, 3 hours after renal biopsy. Contrast CT showing large retroperitoneal haematoma and signs of active bleeding related to the renal mass. Due to hemodynamic instability for a surgical procedure, an angiography was performed for haemorrhage control. The bleeding artery was selectively embolized using PVA microparticles (polyvinyl alcohol). Afterwards the patient favourably recovered from the haemorrhagic shock, deeming the procedure successful.

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Published
2019-09-04
Section
Clinical Case