Angioembolisation von Nierenblutungen

The therapeutic approach to renal hemorrhage has changed in recent decades. In the past, renal trauma was primarily managed by surgical intervention, whereas non-operative management is increasingly preferred today. This shift is largely attributable to improved diagnostic options, particularly multiphase computed tomography, and to the growing availability and use of angioembolization in the treatment of renal hemorrhage. Regardless of the etiology of renal hemorrhage, the CT-based detection of contrast extravasation, a pseudoaneurysm, or an arteriovenous fistula has been described as a predictive factor for the successful use of selective angioembolization in hemodynamically stable patients. The availability of a wide range of different catheters and embolization materials enables interventional radiologists to treat the underlying renal pathology in a minimally-invasive and superselective manner via the arterial vascular system, thereby preserving healthy renal parenchyma and renal function to the greatest extent possible. A key outcome of the increasing use of selective angioembolization in the management of renal hemorrhage is a significant reduction in nephrectomy rates. In due consideration of the limitations of the technique, angioembolization represents an effective and safe procedure that has firmly established itself as an important approach in the non-operative management of renal hemorrhage.