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Clinical and Radiographic Factors Associated With Failed Renal Angioembolization: Results From the Multi-institutional Genitourinary Trauma Study (Mi-GUTS)
Journal article   Open access   Peer reviewed

Clinical and Radiographic Factors Associated With Failed Renal Angioembolization: Results From the Multi-institutional Genitourinary Trauma Study (Mi-GUTS)

Manuel Armas-Phan, Sorena Keihani, Nnenaya Agochukwu-Mmonu, Andrew J Cohen, Douglas M Rogers, Sherry S Wang, Joel A Gross, Ryan P Joyce, Judith C Hagedorn, Bryan Voelzke, …
Urology (Ridgewood, N.J.), Vol.148, pp.287-291
02/2021
DOI: 10.1016/j.urology.2020.10.027
PMID: 33129870
url
https://escholarship.org/content/qt5584q3w0/qt5584q3w0.pdf?t=rj6nrkView
Open Access

Abstract

To find clinical or radiographic factors that are associated with angioembolization failure after high-grade renal trauma. Patients were selected from the Multi-institutional Genito-Urinary Trauma Study. Included were patients who initially received renal angioembolization after high-grade renal trauma (AAST grades III-V). This cohort was dichotomized into successful or failed angioembolization. Angioembolization was considered a failure if angioembolization was followed by repeat angiography and/or an exploratory laparotomy. A total of 67 patients underwent management initially with angioembolization, with failure in 18 (27%) patients. Those with failed angioembolization had a larger proportion ofgrade IV (72% vs 53%) and grade V (22% vs 12%) renal injuries. A total of 53 patients underwent renal angioembolization and had initial radiographic data for review, with failure in 13 cases. The failed renal angioembolization group had larger perirenal hematoma sizes on the initial trauma scan. Angioembolization after high-grade renal trauma failed in 27% of patients. Failed angioembolization was associated with higher injury grade and a larger perirenal hematoma. Likely these characteristics are associated with high-grade renal trauma that may be less amenable to successful treatment after a single renal angioembolization.
Adult Angiography Embolization, Therapeutic - methods Female Humans Kidney - diagnostic imaging Kidney - injuries Male Middle Aged Prospective Studies Treatment Failure Wounds, Nonpenetrating - diagnostic imaging Wounds, Nonpenetrating - therapy Wounds, Penetrating - diagnostic imaging Wounds, Penetrating - therapy Young Adult

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