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MVP (Micro Vascular Plug®) embolization of severe renal hemorrhages after nephrostomic tube placement

BACKGROUND: We report our experience in managing iatrogenic renal bleedings after nephrostomic procedures by transarterial embolization using Micro Vascular Plug (MVP) (Medtronic, USA) as single or complementary embolization device with parenchimal sparing. MATERIALS AND METHODS: Five patients have...

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Autores principales: Giurazza, Francesco, Corvino, Fabio, Cavaglià, Errico, Silvestre, Mattia, Cangiano, Gianluca, Amodio, Francesco, De Magistris, Giuseppe, Niola, Raffaella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966390/
https://www.ncbi.nlm.nih.gov/pubmed/32026228
http://dx.doi.org/10.1186/s42155-019-0087-8
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author Giurazza, Francesco
Corvino, Fabio
Cavaglià, Errico
Silvestre, Mattia
Cangiano, Gianluca
Amodio, Francesco
De Magistris, Giuseppe
Niola, Raffaella
author_facet Giurazza, Francesco
Corvino, Fabio
Cavaglià, Errico
Silvestre, Mattia
Cangiano, Gianluca
Amodio, Francesco
De Magistris, Giuseppe
Niola, Raffaella
author_sort Giurazza, Francesco
collection PubMed
description BACKGROUND: We report our experience in managing iatrogenic renal bleedings after nephrostomic procedures by transarterial embolization using Micro Vascular Plug (MVP) (Medtronic, USA) as single or complementary embolization device with parenchimal sparing. MATERIALS AND METHODS: Five patients have been treated in a single center with transarterial embolization because of renal hemorrhages occurring after positioning of nephrostomic drainages. All patients presented with back pain, severe hematuria and/or bright red blood into the nephrostomic bag, with fall in hemoglobin value. After contrast enhanced CT scan confirming arterial active bleeding, rescue embolization was performed using MVP. The renal parenchimal loss was estimated on final postembolization DSA. Creatinine values were monitored before and after the procedure. RESULTS: Technical and clinical successes were obtained in all patients. Two patients presented with extraluminal blush, one with multiple pseudoaneurysms, one with pseudoaneurysm with arterovenous fistula, one with extraluminal blush with arterovenous fistula. MVP models were choosen oversized because of vasospasm that would underestimate the effective caliber of target vessel; MVP 3Q and MVP 7Q were adopted in one patient each, while MVP 5Q was released in three cases. MVP was the sole embolizing agent in four patients; in one patient, MVP was employed after microcoils failed to obtain complete embolization. The percentage of renal parenchimal lost was lower than 20%; no increase in Creatinine values was detected at dismission. CONCLUSIONS: According to proposed data, MVP seems to be a safe, effective and fast embolizing device that interventionalists could consider when facing renal bleedings, even as sole agent.
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spelling pubmed-69663902020-02-04 MVP (Micro Vascular Plug®) embolization of severe renal hemorrhages after nephrostomic tube placement Giurazza, Francesco Corvino, Fabio Cavaglià, Errico Silvestre, Mattia Cangiano, Gianluca Amodio, Francesco De Magistris, Giuseppe Niola, Raffaella CVIR Endovasc Original Article BACKGROUND: We report our experience in managing iatrogenic renal bleedings after nephrostomic procedures by transarterial embolization using Micro Vascular Plug (MVP) (Medtronic, USA) as single or complementary embolization device with parenchimal sparing. MATERIALS AND METHODS: Five patients have been treated in a single center with transarterial embolization because of renal hemorrhages occurring after positioning of nephrostomic drainages. All patients presented with back pain, severe hematuria and/or bright red blood into the nephrostomic bag, with fall in hemoglobin value. After contrast enhanced CT scan confirming arterial active bleeding, rescue embolization was performed using MVP. The renal parenchimal loss was estimated on final postembolization DSA. Creatinine values were monitored before and after the procedure. RESULTS: Technical and clinical successes were obtained in all patients. Two patients presented with extraluminal blush, one with multiple pseudoaneurysms, one with pseudoaneurysm with arterovenous fistula, one with extraluminal blush with arterovenous fistula. MVP models were choosen oversized because of vasospasm that would underestimate the effective caliber of target vessel; MVP 3Q and MVP 7Q were adopted in one patient each, while MVP 5Q was released in three cases. MVP was the sole embolizing agent in four patients; in one patient, MVP was employed after microcoils failed to obtain complete embolization. The percentage of renal parenchimal lost was lower than 20%; no increase in Creatinine values was detected at dismission. CONCLUSIONS: According to proposed data, MVP seems to be a safe, effective and fast embolizing device that interventionalists could consider when facing renal bleedings, even as sole agent. Springer International Publishing 2019-12-30 /pmc/articles/PMC6966390/ /pubmed/32026228 http://dx.doi.org/10.1186/s42155-019-0087-8 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Giurazza, Francesco
Corvino, Fabio
Cavaglià, Errico
Silvestre, Mattia
Cangiano, Gianluca
Amodio, Francesco
De Magistris, Giuseppe
Niola, Raffaella
MVP (Micro Vascular Plug®) embolization of severe renal hemorrhages after nephrostomic tube placement
title MVP (Micro Vascular Plug®) embolization of severe renal hemorrhages after nephrostomic tube placement
title_full MVP (Micro Vascular Plug®) embolization of severe renal hemorrhages after nephrostomic tube placement
title_fullStr MVP (Micro Vascular Plug®) embolization of severe renal hemorrhages after nephrostomic tube placement
title_full_unstemmed MVP (Micro Vascular Plug®) embolization of severe renal hemorrhages after nephrostomic tube placement
title_short MVP (Micro Vascular Plug®) embolization of severe renal hemorrhages after nephrostomic tube placement
title_sort mvp (micro vascular plug®) embolization of severe renal hemorrhages after nephrostomic tube placement
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966390/
https://www.ncbi.nlm.nih.gov/pubmed/32026228
http://dx.doi.org/10.1186/s42155-019-0087-8
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