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Clinical factors that influence the occurrence of symptomatic pseudoaneurysms and arteriovenous fistulas after partial nephrectomy: multi-institutional study of renal function outcomes after one year of selective arterial embolization
Lee, Chan Ho; Ha, Hong Koo; Ku, Ja Yoon; Seo, Won Ik; Choi, Seock Hwan.
Afiliação
  • Lee, Chan Ho; Inje University College of Medicine. Inje University Busan Paik Hospital. Department of Urology. Busan. KR
  • Ha, Hong Koo; Pusan National University School of Medicine. Pusan National University Hospital. Department of Urology. Busan. KR
  • Ku, Ja Yoon; Pusan National University School of Medicine. Pusan National University Hospital. Department of Urology. Busan. KR
  • Seo, Won Ik; Inje University College of Medicine. Inje University Busan Paik Hospital. Department of Urology. Busan. KR
  • Choi, Seock Hwan; Kyungpook National University. School of Medicine. Department of Urology. Daegu. KR
Int. braz. j. urol ; 47(1): 149-158, Jan.-Feb. 2021. tab, graf
Article em En | LILACS | ID: biblio-1134310
Biblioteca responsável: BR1.1
ABSTRACT
ABSTRACT

Purpose:

Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function. Materials and

Methods:

Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated.

Results:

Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p <0.05). In the multivariate analysis, higher N component scores were associated with the occurrence of RAPs/AVFs (Odds ratio 1.96, p=0.039). In the SAE group, the mean 3-day postembolization eGFR was significantly lower than the mean 3-day postoperative eGFR (p <0.01). This difference in the eGFRs was still present 1 year later.

Conclusions:

Renal tumors located near the renal sinus and collecting system were associated with a higher risk for RAPs/AVFs after PN. Although SAE was an effective method for controlling symptomatic RAPs/AVFs after PN, a procedure-related impairment of renal function after SAE could occur and still be present at the end of the first postoperative year.
Assuntos
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Fístula Arteriovenosa / Falso Aneurisma / Neoplasias Renais Tipo de estudo: Diagnostic_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Int. braz. j. urol Assunto da revista: UROLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Coréia do Sul País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Assunto principal: Fístula Arteriovenosa / Falso Aneurisma / Neoplasias Renais Tipo de estudo: Diagnostic_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Int. braz. j. urol Assunto da revista: UROLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Coréia do Sul País de publicação: Brasil