Management of Traumatic Hematuria by Selective Renal Artery Embolization

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Abstract
Angiography and selective renal arterial embolization were performed in 17 patients with traumatic lesions of the kidney and hematuria. Of the patients 8 had retroperitoneal extravasation of contrast medium owing to rupture, 6 had traumatic arteriovenous fistulas and 5 had pseudoaneurysms. Immediate control of hemorrhage was achieved in 16 patients (94.1%), while delayed control was obtained in 1. Hematuria recurred in 4 of the 17 patients (23.5%) and resulted in total nephrectomy in 3 (17.6%) despite repeated embolization in 2. Embolization alone was successful in 14 patients (82.4%). According to the followup preservation of renal function and viable parenchyma was excellent in all embolized patients. Transcatheter embolization should be performed in patients with renal trauma and uncontrollable hematuria before any surgical attempt is made.