iRESCUE - Interventional embolization of Renal artEries after SurgiCal or traUmatic injury with hEmorrhage.

Abstract Objectives To evaluate the efficacy and safety of urgent percutaneous embolization for the treatment of acute renal hemorrhage. Materials and Methods All patients undergoing endovascular embolization at our hospital for bleeding from renal artery branches between January 2010 and June 2020 were retrospectively evaluated. Periprocedural characteristics, technical details, clinical outcomes, and complications were documented. Results Seventy-six patients with a mean age of 67.3 ± 12.9 underwent 86 procedures. The most common cause of hemorrhage was iatrogenic (63/76), including 44 patients presenting after partial nephrectomy. Bleeding was successfully controlled in 80 of 86 procedures (92.8% technical success), and clinical success (defined as control of bleeding with endovascular embolization) was achieved in 72 of 76 patients (94.5%) with embolization, including seven patients undergoing re-intervention. In univariate analysis, risk factors for clinical failure were antiplatelet agents (p = 0.033), and technical failure (p  Conclusion Interventional embolization is feasible, safe, and effective in the treatment of renal hemorrhages. Among others, the complication management with minimally invasive procedures allows urologists to safely perform partial nephrectomy even in patients with central, large, and endophytic tumors, thereby preserving kidney function in these patients.