Selective Embolization of Traumatic Vascular Kidney Injury
A 78-year-old man was admitted to the emergency department and underwent a total body CT scan after a car accident. The scans showed a large subcapsular hematoma with active arterial supply at the middle-lower third level of the left kidney (Figure 1).
A 2.4-F Direxion™ Torqueable Microcatheter was used to engage the left renal artery and perform a super-selective catheterization of the middle-inferior lobe vessels. The angiogram confirmed active bleeding due to arterial laceration (Figure 2).
The first embolization was performed with 3- X 40-mm Interlock-18™ Detachable Coils. Using the same Direxion™ Microcatheter, with accurate torquablility, we were able to perform distal embolization, preserving renal parenchyma by using a 2- X 40-mm Interlock-18™ Fibered Detachable Coil (Figure 3).
FOLLOW-UP AND DISCUSSION
Final angiography confirmed a very good and precise embolization. After 5 days, CT scan showed a capsular hematoma reduction and absence of active bleeding (Figure 4).
Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.
Angelo Spinazzola, MD
Chief of Interventional Radiology
Nicola Cionfoli, MD