Successful Renal Transcatheter Arterial Embolization in Three Patients with Symptomatic Hydronephrosis Due to Ureteral Obstruction

Abstract

Background: Conventional treatments for symptomatic enlargement of a nonfunctional hydronephrotic kidney caused by obstructive uropathy include surgical treatments.
Methods: Patients included a 67-year-old woman whose obstruction was caused by a lower urinary tract stone complicating spinal tuberculosis (patient 1); a 52-year-old man with compressive complete congenital obstruction crossing the ureteropelvic junction from an abberant renal artery (patient 2); and a 19-year-old woman with essentially complete idiopathic congenital obstruction at the ureteropelvic junction (patient 3), who required antibiotics for pyelonephritis before embolization. The renal artery was embolized using platinum microcoils.
Results: Although the sensation of abdominal fullness diminished within approximately two week after TAE, it took one to two yeaes until the embolized kidney size shrank from 1377±634 cm³ (range, 829 to 2072) to 43±46 cm³ (42 to 94) by the evaluation of computed tomography. Fever after embolization persisted for 5 days in patient 1, 3 in patient 2, and 9 in patient 3. Flank pain resolved within 5 days in all. Pyelonephritis and complications of treatment have not occurred.
Conclusion: Embolization for this indication was safe and effective.