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2015 ; 2015
(ä): 981251
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Open Partial Nephrectomy for High-Risk Renal Masses Is Associated with Renal
Pseudoaneurysms: Assessment of a Severe Procedure-Related Complication
#MMPMID26539549
Kriegmair MC
; Mandel P
; Rathmann N
; Diehl SJ
; Pfalzgraf D
; Ritter M
Biomed Res Int
2015[]; 2015
(ä): 981251
PMID26539549
show ga
OBJECTIVES: A symptomatic renal pseudoaneurysm (RPA) is a severe complication
after open partial nephrectomy (OPN). The aim of our study was to assess
incidence and risk factors for RPA formation. Furthermore, we present our
management strategy. PATIENTS AND METHODS: Clinical records of consecutive
patients undergoing OPN were assessed for surgical outcome and postoperative
complications. Renal masses were risk stratified for tumor complexity according
to the PADUA score. Uni- and multivariate analysis for symptomatic RPAs were
performed using the t-tests and logistic regression. RESULTS: We identified 233
patients treated with OPN. Symptomatic RPAs were observed in 13 (5.6%) patients,
on average 14 (4-42) days after surgery. Uni- and multivariate analysis
identified tumor complexity to be an independent predictor for symptomatic RPAs
(p = 0.004). There was a significant correlation between RPAs and transfusion and
the duration of stay (p < 0.001 and p = 0.021). Symptomatic RPAs were diagnosed
with CT scans and successfully treated with arterial embolization. DISCUSSION:
Symptomatic RPAs are not uncommon after OPN for high-risk renal masses. A high
nephrometry score is a predictor for this severe complication and may enable a
risk-stratified followup. RPAs can successfully be located by CT angiography,
which enables targeted angiographic treatment.