J Korean Soc Radiol.  2019 Jul;80(4):643-655. 10.3348/jksr.2019.80.4.643.

Role of Transarterial Embolization in the Management of Urologic Diseases

• Han K

• KMID: 2457444
• DOI: http://doi.org/10.3348/jksr.2019.80.4.643

Abstract

Transarterial embolization has been widely utilized in the management of urologic diseases. Acute hemorrhage can be caused by tumor, trauma, and percutaneous procedures and is the most common indication for embolization. In the past, surgical intervention was the standard treatment for urological bleeding. However, it entailed high morbidity and mortality. The demand for less-invasive treatments led to the use of transarterial embolization as an alternative to surgery. Embolization is a safe and effective treatment option for hemorrhage in various urological organs. Additionally, embolization has been employed to prevent or treat hemorrhage associated with angiomyolipoma or to treat high-flow priapism. Embolization of the target vessel in a superselective manner and use of appropriate embolic materials are key to a safe and effective procedure.

MeSH Terms

Angiomyolipoma
Embolization, Therapeutic
Hemorrhage
Mortality
Priapism
Urologic Diseases*
Urologic Neoplasms

Figure

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  Fig. 1 Patient who developed hematuria after partial nephrectomy for renal cell carcinoma. A. CT reveals a pseudoaneurysm (arrow) arising from the renal artery. B, C. Renal angiography demonstrates a pseudoaneurysm (arrow), which is superselected using a microcatheter. D. The pseudoaneurysm was completely excluded after embolization using n-butyl cyanoacrylate glue.

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  Fig. 2 Angiomyolipoma patient who complained of flank pain. A. CT shows angiomyolipoma (*) in the upper pole of the left kidney. B. Renal angiography demonstrates the tumor. C. The lesion is superselected and embolized using polyvinyl alcohol particles (250–355 µm). D. The tumor (*) decreases in size on the 6-month follow-up CT.

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  Fig. 3 A 49-year-old male who developed hemorrhage after percutaneous renal biopsy. A. CT reveals a pseudoaneurysm and hematoma in the kidney. B. Renal angiography shows a pseudoaneurysm (arrow). C. The affected branch is embolized using n-butyl cyanoacrylate glue and vascular plug. D. Follow-up CT shows mild atrophy of the renal parenchyma, supplied by the embolized vessel. CT = computed tomography

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  Fig. 4 Bladder cancer patient who complained of hematuria. A. CT shows a tumor on the left side of the bladder. B. The mass is opacified on left internal iliac angiography. C. The feeding artery is superselected and embolized using Gelfoam.

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  Fig. 5 A 34-year-old male who developed priapism. A. Penile angiography shows contrast extravasation. B. Embolization is performed using gelfoam.

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