Renal function outcomes following selective angioembolization for iatrogenic vascular lesions after partial nephrectomy

Jeffrey Gahan, Mansi Gaitonde, Luis Wadskier, Jeffrey A Cadeddu, Clayton K Trimmer

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: To report one of the largest series of clinical and renal function outcomes of treated iatrogenic vascular lesions (IVL) after partial nephrectomy (PN). Angioembolization (AE) is the treatment of choice for patients with these lesions, but the additional renal injury conferred by this treatment has not been well described. Patients and Methods: Patients who underwent open, laparoscopic, or robot-assisted PN from 2002 to 2012 were identified and those with AE were selected. Patients' charts were reviewed, and renal function was analyzed using estimated glomerular filtration rate (eGFR) and progression of chronic kidney disease (CKD) classification before and after PN and AE. Results: There were 849 patients who underwent PN and an IVL developed in 28 (3.3%). Twenty (71%) presented with gross hematuria at a mean of 10.2±7.7 days after PN and 8 (28%) needed transfusion. All patients had identifiable IVL at the time of selective AE, and technical success was achieved in 24/28 (86%), although 4 needed subsequent additional AE. The paired decrease in eGFR after PN was significant (P<0.01), while the paired change in eGFR after AE was not with either short-term (2.8 days) or intermediate-term (362 days) follow-up (P=0.50). Four patients experienced transient worsening in CKD classification after AE, although three experienced CKD stage improvement. Conclusion: Selective AE for IVL after PN is safe, efficacious, and does not lead to a significant impairment of renal function. It remains the preferred approach for the evaluation and management of post-PN hemorrhage.

Original languageEnglish (US)
Pages (from-to)1516-1519
Number of pages4
JournalJournal of Endourology
Volume27
Issue number12
DOIs
StatePublished - Dec 1 2013

Fingerprint

Nephrectomy
Blood Vessels
Kidney
Glomerular Filtration Rate
Chronic Renal Insufficiency
Hematuria
Hemorrhage
Wounds and Injuries
Therapeutics

ASJC Scopus subject areas

  • Urology

Cite this

Renal function outcomes following selective angioembolization for iatrogenic vascular lesions after partial nephrectomy. / Gahan, Jeffrey; Gaitonde, Mansi; Wadskier, Luis; Cadeddu, Jeffrey A; Trimmer, Clayton K.

In: Journal of Endourology, Vol. 27, No. 12, 01.12.2013, p. 1516-1519.

Research output: Contribution to journalArticle

@article{6c251aa8627b4e67a8f732160998b991,
title = "Renal function outcomes following selective angioembolization for iatrogenic vascular lesions after partial nephrectomy",
abstract = "Purpose: To report one of the largest series of clinical and renal function outcomes of treated iatrogenic vascular lesions (IVL) after partial nephrectomy (PN). Angioembolization (AE) is the treatment of choice for patients with these lesions, but the additional renal injury conferred by this treatment has not been well described. Patients and Methods: Patients who underwent open, laparoscopic, or robot-assisted PN from 2002 to 2012 were identified and those with AE were selected. Patients' charts were reviewed, and renal function was analyzed using estimated glomerular filtration rate (eGFR) and progression of chronic kidney disease (CKD) classification before and after PN and AE. Results: There were 849 patients who underwent PN and an IVL developed in 28 (3.3{\%}). Twenty (71{\%}) presented with gross hematuria at a mean of 10.2±7.7 days after PN and 8 (28{\%}) needed transfusion. All patients had identifiable IVL at the time of selective AE, and technical success was achieved in 24/28 (86{\%}), although 4 needed subsequent additional AE. The paired decrease in eGFR after PN was significant (P<0.01), while the paired change in eGFR after AE was not with either short-term (2.8 days) or intermediate-term (362 days) follow-up (P=0.50). Four patients experienced transient worsening in CKD classification after AE, although three experienced CKD stage improvement. Conclusion: Selective AE for IVL after PN is safe, efficacious, and does not lead to a significant impairment of renal function. It remains the preferred approach for the evaluation and management of post-PN hemorrhage.",
author = "Jeffrey Gahan and Mansi Gaitonde and Luis Wadskier and Cadeddu, {Jeffrey A} and Trimmer, {Clayton K}",
year = "2013",
month = "12",
day = "1",
doi = "10.1089/end.2013.0201",
language = "English (US)",
volume = "27",
pages = "1516--1519",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "12",

}

TY - JOUR

T1 - Renal function outcomes following selective angioembolization for iatrogenic vascular lesions after partial nephrectomy

AU - Gahan, Jeffrey

AU - Gaitonde, Mansi

AU - Wadskier, Luis

AU - Cadeddu, Jeffrey A

AU - Trimmer, Clayton K

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Purpose: To report one of the largest series of clinical and renal function outcomes of treated iatrogenic vascular lesions (IVL) after partial nephrectomy (PN). Angioembolization (AE) is the treatment of choice for patients with these lesions, but the additional renal injury conferred by this treatment has not been well described. Patients and Methods: Patients who underwent open, laparoscopic, or robot-assisted PN from 2002 to 2012 were identified and those with AE were selected. Patients' charts were reviewed, and renal function was analyzed using estimated glomerular filtration rate (eGFR) and progression of chronic kidney disease (CKD) classification before and after PN and AE. Results: There were 849 patients who underwent PN and an IVL developed in 28 (3.3%). Twenty (71%) presented with gross hematuria at a mean of 10.2±7.7 days after PN and 8 (28%) needed transfusion. All patients had identifiable IVL at the time of selective AE, and technical success was achieved in 24/28 (86%), although 4 needed subsequent additional AE. The paired decrease in eGFR after PN was significant (P<0.01), while the paired change in eGFR after AE was not with either short-term (2.8 days) or intermediate-term (362 days) follow-up (P=0.50). Four patients experienced transient worsening in CKD classification after AE, although three experienced CKD stage improvement. Conclusion: Selective AE for IVL after PN is safe, efficacious, and does not lead to a significant impairment of renal function. It remains the preferred approach for the evaluation and management of post-PN hemorrhage.

AB - Purpose: To report one of the largest series of clinical and renal function outcomes of treated iatrogenic vascular lesions (IVL) after partial nephrectomy (PN). Angioembolization (AE) is the treatment of choice for patients with these lesions, but the additional renal injury conferred by this treatment has not been well described. Patients and Methods: Patients who underwent open, laparoscopic, or robot-assisted PN from 2002 to 2012 were identified and those with AE were selected. Patients' charts were reviewed, and renal function was analyzed using estimated glomerular filtration rate (eGFR) and progression of chronic kidney disease (CKD) classification before and after PN and AE. Results: There were 849 patients who underwent PN and an IVL developed in 28 (3.3%). Twenty (71%) presented with gross hematuria at a mean of 10.2±7.7 days after PN and 8 (28%) needed transfusion. All patients had identifiable IVL at the time of selective AE, and technical success was achieved in 24/28 (86%), although 4 needed subsequent additional AE. The paired decrease in eGFR after PN was significant (P<0.01), while the paired change in eGFR after AE was not with either short-term (2.8 days) or intermediate-term (362 days) follow-up (P=0.50). Four patients experienced transient worsening in CKD classification after AE, although three experienced CKD stage improvement. Conclusion: Selective AE for IVL after PN is safe, efficacious, and does not lead to a significant impairment of renal function. It remains the preferred approach for the evaluation and management of post-PN hemorrhage.

UR - http://www.scopus.com/inward/record.url?scp=84890480301&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890480301&partnerID=8YFLogxK

U2 - 10.1089/end.2013.0201

DO - 10.1089/end.2013.0201

M3 - Article

C2 - 24199730

AN - SCOPUS:84890480301

VL - 27

SP - 1516

EP - 1519

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 12

ER -