Severe bleeding following laparoscopic partial nephrectomy treated by selective renal artery embolization - initial experience and review of the literature

Purpose : Partial nephrectomy (PN) is an accepted alternative to radical nephrectomy for nephron sparing surgery to treat renal tumors. Although complications are relatively rare after PN, they may include renal hemorrhage that can be massive and life threatening. Artery embolization can have a major role in the management of these cases and to avoid radical nephrectomy. Materials and methods : We report three consecutive patients with massive hemorrhage after LAPN, treated by arterial embolization and review the literature to discuss the clinical presentation, imaging evaluation and clinical outcome. Results : After selective catheterization and identification of the bleeding site, micro-coils were used as embolization material. Immediate technical and clinical success was achieved in all cases. Conclusion : Superselective artery embolization of renal hemorrhage is a simple, safe and efficient procedure. It has a high clinical success and should be considered as an alternative to nephrectomy, minimizing the morbidity and preserving renal tissue.