RENAL ARTERY EMBOLISATION FOR RENAL BLEED (BLOOD IN URINE)

What is renal artery embolisation:

• Renal artery embolisation is a minimally invasive procedure for treatment of renal bleed (blood in urine). 
• It involves blockage of leaky vessel to prevent life threatening haemorrhage through small pinhole (less than 2 mm).

What are the reasons for renal bleed:

Common reasons of renal bleed are:

• Pseudo aneurysm
• Vascular malformation
• Iatrogenic injury
• Tumors (Renal cell carcinoma, Angiomyolipoma)
• Trauma

Why it is necessary:

• It is necessary for prevention of excessive blood loss through urine and thus life saving procedure.

How it is done:

• The interventional radiologist will insert a catheter (tube) into a blood vessel in groin and will guide the catheter under image guidance to the renal artery. 
• Superselective catheterization of renal artery branches involves the use of microcatheters either via coaxial or guidewire-controlled techniques.
• Embolization of affected vessel done with alcohol, polyvinyl alcohol (PVA) particles, microspheres, and/or Gelfoam until there is contrast stasis in the targeted kidney.  Detachable coils are also routinely used for embolisation.
• Depending on the indication and the character of the disease, different embolic materials and catheters should be used to optimize outcomes.

What are the benefits:

• Renal artery embolization is considered a safe and effective procedure with a very low complication rate. 
• Very short hospital stay and no stitches as procedure involve very small pinhole.

Preparation for procedure:

• Few basic blood investigations like CBC, PT/INR, viral markers.
• Fasting for 4-6 hrs.
• Bring all the records including imaging record.
• Signing consent form.

What are risk:

• Very rare; Bleeding, stent thrombosis and renal infarction.