Interventional Treatment for Post-biopsy Renal Artery Pseudoaneurysm

Excerpt

To the Editor: A 13-y-old boy was admitted to our hospital because of gross hematuria for 4 h and recurring abnormal urine for 4 y. He was diagnosed as Henoch-Schönlein purpura (HSP) 4 y back. Gross hematuria occurred after renal biopsy and with active treatment for 3 d, hematuria alleviated. However, gross hematuria re-emerged after vigorous skipping. The blood RT showed Hb decreasing rapidly from 120 g/L to 74 g/L. Renal color doppler ultrasound and contrast-enhanced CT suggested a renal artery pseudoaneurysm (Fig. 1a). Conservative treatment did not work well and we decided to perform renal artery angiography and embolization. A contrast extravasation was found to the descending branch of right renal artery, thus confirmed the diagnosis of pseudoaneurysm rupture (Fig. 1b). We inserted SP micro catheter to the lower pole of the right kidney lesions for infusion of 3–5 0.2 × 0.2 mm gelatin sponge particles and 2 mm metal coils (Fig. 1c). The interventional treatment turned out to be a success. On follow-up of 6 mo we saw no recurrence of hematuria.

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