Renal artery embolization is a medical procedure that involves intentionally blocking the blood supply to a kidney or a specific part of it. This minimally invasive technique is performed in a hospital’s radiology department to manage certain kidney conditions.
What is Renal Artery Embolization?
Renal artery embolization involves the targeted occlusion of blood vessels within the kidney. The primary goal is to interrupt the flow of oxygen and nutrients to a specific area, preventing further growth or activity of abnormal tissue. This is achieved by introducing embolic agents into the renal artery, which then block smaller blood vessels.
This non-surgical, image-guided technique treats various kidney-related issues. It allows for precise delivery and effective blockage of the targeted blood supply.
Conditions It Treats
Renal artery embolization is performed for several medical conditions where blocking kidney blood flow provides therapeutic benefits. A frequent indication is the preoperative management of kidney cancer, especially for large and highly vascular tumors. By reducing the tumor’s size and blood supply, the procedure can decrease the risk of significant bleeding during subsequent surgical removal of the kidney, known as nephrectomy.
The procedure also provides palliative care for patients with unresectable kidney cancer or those who cannot undergo surgery due to other health issues. In such cases, embolization helps to reduce tumor size and alleviate symptoms like pain or uncontrollable bleeding (hematuria). It can offer temporary relief.
Uncontrollable bleeding from the kidney, often resulting from trauma, kidney biopsy, or other medical procedures, is another reason for embolization. This approach helps to stop active hemorrhage by sealing off damaged blood vessels. Additionally, vascular malformations within the kidney, such as arteriovenous fistulas or pseudoaneurysms, can be treated effectively by blocking the abnormal connections. These malformations can arise from percutaneous biopsies of kidney transplants.
How the Procedure is Performed
Before renal artery embolization, patients prepare with blood tests and fasting instructions. Any blood-thinning medications may need temporary discontinuation. The procedure begins with local anesthesia at the insertion site, commonly in the groin.
A small incision is made, and a thin, flexible tube called a catheter is inserted into a major artery, such as the femoral artery in the groin or sometimes an artery in the wrist. Using real-time imaging guidance, primarily fluoroscopy, the interventional radiologist carefully navigates the catheter through the blood vessels. This allows precise visualization of the catheter’s path as it is advanced towards the renal artery.
Once the catheter reaches the renal artery, a contrast dye is often injected to create a clear image of the kidney’s blood vessels and identify the specific area requiring embolization. Following this, various embolic agents are injected through the catheter to block the blood flow. These agents can include metallic microcoils, liquid agents, or microscopic particles such as acrylic microspheres or polyvinyl alcohol particles. The choice of agent depends on the specific condition being treated and the size of the vessels to be occluded.
The embolic agents intentionally cause a blockage, depriving the targeted area of blood supply. After successful embolization, the catheter is carefully removed from the artery. Pressure is then applied to the insertion site to prevent bleeding. Patients are observed for several hours or overnight in the hospital following the procedure.
Potential Side Effects and Recovery
Following renal artery embolization, patients commonly experience temporary symptoms known as post-embolization syndrome. This syndrome can include flank pain, fever, nausea, vomiting, and an increase in white blood cell count (leukocytosis). These symptoms are self-limiting and resolve within one to three days.
Supportive care, such as pain relievers, anti-nausea medication, and fever reducers, is provided to manage these symptoms. Patients are advised to rest for at least four hours immediately after the procedure. A hospital stay of one to two nights is common for monitoring and symptom control.
Patients are monitored for less common occurrences such as vascular injury or groin hematoma. It is important for individuals to follow post-procedure care instructions and report any concerning or worsening symptoms to their medical team. The procedure is generally safe with a low complication rate, and understanding expected side effects aids recovery.