[Interventional radiology in the area of the renal blood vessels. Percutaneous transluminal angioplasty and embolization]

Abstract

Recanalization (angioplasty) and occlusion (embolization) are the major interventional radiological procedures used in renal vessels. In recanalization of the renal artery, percutaneous transluminal angioplasty of renal arterial stenosis is the most common procedure. About 80% of renal arterial stenoses are suitable for this procedure, that is, about 80% of patients can be spared major abdominal surgery. Methods, results and complications are discussed. Local lysis of acute renal arterial occlusions is rarely employed, since the diagnosis is usually made too late. Functional improvements may be expected even when recanalization is successful only when the procedure is performed within one hour of the occlusion or when collaterals suffice for organ-preserving metabolic activities. Embolization of the renal artery is employed in particular in the case of tumors of the kidneys, more frequently with a pre-operative rather than a palliative intent. Pre-operative embolization aims at facilitating surgery and reducing the need for transfused blood. The palliative procedure employed in inoperable tumors aims at prolonging life, controlling acute bleeds, and combatting paraneoplastic syndromes. The method is described.