EURORAD ESR

Case 2899

Embolization of kidney pseudoaneurysm following partial nephrectomy

Author(s)
Pratali A, Granai G, Bargellini I, Perri M, Bartolozzi C
 
Patient
male, 57 year(s)
 
 
  • Figure 1
    A CT examination performed 20 days after the left renal nodulectomy.
     

    An unenhanced CT scan showing a large hyperdense fluid collection at the level of the previous left renal nodulectomy; the ispilateral excretory tract is enlarged and filled by a hyperdense material, due to blood...

     
    Area of Interest: unknown; Imaging Technique: CT examination performed 20 days after left renal nodulectomy.;

    In the arterial phase, the fluid collection showing a high contrast-enhancement, allowing the diagnosis of a large pseudoaneurysm.

     
    Area of Interest: unknown; Imaging Technique: CT examination performed 20 days after left renal nodulectomy.;

    A multiplanar volumetric reconstruction clearly showing one of the multiple arterial feeders of the pseudoaneurysm.

     
    Area of Interest: unknown; Imaging Technique: CT examination performed 20 days after left renal nodulectomy.;
     
     
  • Figure 2
    A diagnostic DSA and a superselective coil embolization procedure.
     

    A selective left renal arteriograph showing the large pseudoaneurysm supplied by branches of the segmental arteries of the middle and inferior portions of the kidney.

     
    Area of Interest: unknown; Imaging Technique: Diagnostic DSA and superselective coil embolization procedure.;

    A selective left renal arteriograph immediately after coil embolization demonstrating the devascularization of the lesion. No local complications occurred.

     
    Area of Interest: unknown; Imaging Technique: Diagnostic DSA and superselective coil embolization procedure.;
     
     
  • Figure 3
    A CT examination performed 14 days after the coil embolization.
     

    A contrast enhanced CT scan showing a persitent spot of arterial enhancement within the thrombosed pseudoaneurysm.

     
    Area of Interest: unknown; Imaging Technique: CT examination performed 14 days after coil embolization.;

    A multiplanar volumetric reconstruction demonstrating the tiny interlobular artery supplying the pseudoaneurysm. Coil artifacts can be appreciated.

     
    Area of Interest: unknown; Imaging Technique: CT examination performed 14 days after coil embolization.;
     
     
  • Figure 4
    A diagnostic DSA and repeated percutaneous coil embolization.
     

    A selective left renal arteriograph confirming the CT findings.

     
    Area of Interest: unknown; Imaging Technique: Diagnostic DSA and repeated percutaneous coil embolization.;

    Superselective DSA at the level of the interlobular artery is performed to confirm the persisting feeding of the pseudoaneurysm.

     
    Area of Interest: unknown; Imaging Technique: Diagnostic DSA and repeated percutaneous coil embolization.;

    A post-procedural selective left renal arteriograph showing a complete devascularization of the lesion after selective occlusion of the interlobular artery. No complications occurred during or immediately after the...

     
    Area of Interest: unknown; Imaging Technique: Diagnostic DSA and repeated percutaneous coil embolization.;
     
     
  • Figure 5
    A CT examination performed 6 days after the second percutaneous embolization.
     

    An unenhanced CT scan showing air and persistence of the contrast medium at the level of the embolized pseudoaneurysm; the findings are probably related to the recent coil embolization.

     
    Area of Interest: unknown; Imaging Technique: CT examination performed 6 days after the second percutaneous embolization.;

    A contrast enhanced CT scan demonstrating the successful devascularization of the pseudoaneurysm. No arterial enhancement is demonstrated within the lesion. The residual parenchyma shows a regular arterial enhancement.

     
    Area of Interest: unknown; Imaging Technique: CT examination performed 6 days after the second percutaneous embolization.;
     
     
An unenhanced CT scan showing a large hyperdense fluid collection at the level of the previous left renal nodulectomy; the ispilateral excretory tract is enlarged and filled by a hyperdense material, due to blood clots. An irregular fluid collection at the left flank is due to the recent surgical incision. Metallic clips are visualized at the renal hilum.
 
In the arterial phase, the fluid collection showing a high contrast-enhancement, allowing the diagnosis of a large pseudoaneurysm.
 
A multiplanar volumetric reconstruction clearly showing one of the multiple arterial feeders of the pseudoaneurysm.
 
A selective left renal arteriograph showing the large pseudoaneurysm supplied by branches of the segmental arteries of the middle and inferior portions of the kidney.
 
A selective left renal arteriograph immediately after coil embolization demonstrating the devascularization of the lesion. No local complications occurred.
 
A contrast enhanced CT scan showing a persitent spot of arterial enhancement within the thrombosed pseudoaneurysm.
 
A multiplanar volumetric reconstruction demonstrating the tiny interlobular artery supplying the pseudoaneurysm. Coil artifacts can be appreciated.
 
A selective left renal arteriograph confirming the CT findings.
 
Superselective DSA at the level of the interlobular artery is performed to confirm the persisting feeding of the pseudoaneurysm.
 
A post-procedural selective left renal arteriograph showing a complete devascularization of the lesion after selective occlusion of the interlobular artery. No complications occurred during or immediately after the embolizaion. The upper portion of the kidney is still regularly perfused.
 
An unenhanced CT scan showing air and persistence of the contrast medium at the level of the embolized pseudoaneurysm; the findings are probably related to the recent coil embolization.
 
A contrast enhanced CT scan demonstrating the successful devascularization of the pseudoaneurysm. No arterial enhancement is demonstrated within the lesion. The residual parenchyma shows a regular arterial enhancement.
 
 
 
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