KẾT QUẢ NÚT MẠCH THẬN CHỌN LỌC ĐIỀU TRỊ CHẢY MÁU SAU TÁN SỎI THẬN QUA DA

Abstract

The purpose of this study was to describe the clinical and laboratory features evaluate the therapeutic efficacy and safety of superselective renal arterial embolization (SRAE) in the treatment of patients with renal hemorrhage after percutaneous nephrolithotomy (PCNL). From January 2019 to May 2023, data of 32 consecutive patients with SRAE management of post-PCNL hemorrhage were retrospectively analyzed. The mean age of patients was 51.6 ± 10.3 years and There were 11 patients (34.4%) who had chronic diseases. The mean interval between surgery and the angiography was 11.3 ± 7.6 days. Hematuria was the most common symptom (100%), followed by flank pain (56.3%), red fluid in the drainage bag (15.6%) and 3 patients (9.4%) with blood loss shock. The mean reduced hemoglobin was 3.4 g/dl and blood transfusion rate was 37.5%. There were 29 patients (90.6%) who received computed tomography (CT) before angiography and 28 out of total patients (96.6%) detected bleeding foci. The most common bleeding site was mid-pole with 43.8% and the most common angiographic finding was pseudoaneurysm (62.5%). Bio glue was the most commonly used plug material (75.0%). There were 31 pastients (96.9%) required only one session of SRAE and 1 patient (3.1%) needed two sessions. The initial success rate of embolization was 96.9% after the first SRAE and this figure rose to 100% after second SRAE. There were 43.8% patients presenting with post-embolization syndrome. Post-embolization hospital stay was 5.8 ± 3.6 days. It was evident from the study that SRAE is an efficacious and safe procedure in treatment of post-PCNL hemorrhage.