Clinical factors that influence the occurrence of symptomatic pseudoaneurysms and arteriovenous fistulas after partial nephrectomy: multi-institutional study of renal function outcomes after one year of selective arterial embolization
Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurre...
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| Veröffentlicht in: | International Brazilian Journal of Urology 2021-01, Vol.47 (1), p.149-158 |
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| creator | Lee, Chan Ho Ha, Hong Koo Ku, Ja Yoon Seo, Won Ik Choi, Seock Hwan |
| description | Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function.
Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated.
Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p |
| doi_str_mv | 10.1590/S1677-5538.IBJU.2019.0789 |
| format | Article |
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Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated.
Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p <0.05). In the multivariate analysis, higher N component scores were associated with the occurrence of RAPs/AVFs (Odds ratio: 1.96, p=0.039). In the SAE group, the mean 3-day postembolization eGFR was significantly lower than the mean 3-day postoperative eGFR (p <0.01). This difference in the eGFRs was still present 1 year later.
Renal tumors located near the renal sinus and collecting system were associated with a higher risk for RAPs/AVFs after PN. Although SAE was an effective method for controlling symptomatic RAPs/AVFs after PN, a procedure-related impairment of renal function after SAE could occur and still be present at the end of the first postoperative year.</description><identifier>ISSN: 1677-5538</identifier><identifier>EISSN: 1677-6119</identifier><identifier>DOI: 10.1590/S1677-5538.IBJU.2019.0789</identifier><identifier>PMID: 33047920</identifier><language>eng</language><publisher>Brazil: Sociedade Brasileira de Urologia</publisher><subject>Aneurysm, False ; Aneurysm, False - etiology ; Arteriovenous Fistula ; Arteriovenous Fistula - etiology ; Glomerular Filtration Rate ; Humans ; Kidney Neoplasms - surgery ; Nephrectomy ; Nephrectomy - adverse effects ; Original ; Retrospective Studies ; Treatment Outcome</subject><ispartof>International Brazilian Journal of Urology, 2021-01, Vol.47 (1), p.149-158</ispartof><rights>Copyright® by the International Brazilian Journal of Urology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-f6810ef11bdd08d28432dc8bca1151869f4a3ceb37ba03b7dcbc27f5bd52eee73</citedby><cites>FETCH-LOGICAL-c528t-f6810ef11bdd08d28432dc8bca1151869f4a3ceb37ba03b7dcbc27f5bd52eee73</cites><orcidid>0000-0002-7750-6806</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712700/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712700/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33047920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Chan Ho</creatorcontrib><creatorcontrib>Ha, Hong Koo</creatorcontrib><creatorcontrib>Ku, Ja Yoon</creatorcontrib><creatorcontrib>Seo, Won Ik</creatorcontrib><creatorcontrib>Choi, Seock Hwan</creatorcontrib><title>Clinical factors that influence the occurrence of symptomatic pseudoaneurysms and arteriovenous fistulas after partial nephrectomy: multi-institutional study of renal function outcomes after one year of selective arterial embolization</title><title>International Brazilian Journal of Urology</title><addtitle>Int Braz J Urol</addtitle><description>Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function.
Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated.
Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p <0.05). In the multivariate analysis, higher N component scores were associated with the occurrence of RAPs/AVFs (Odds ratio: 1.96, p=0.039). In the SAE group, the mean 3-day postembolization eGFR was significantly lower than the mean 3-day postoperative eGFR (p <0.01). This difference in the eGFRs was still present 1 year later.
Renal tumors located near the renal sinus and collecting system were associated with a higher risk for RAPs/AVFs after PN. Although SAE was an effective method for controlling symptomatic RAPs/AVFs after PN, a procedure-related impairment of renal function after SAE could occur and still be present at the end of the first postoperative year.</description><subject>Aneurysm, False</subject><subject>Aneurysm, False - etiology</subject><subject>Arteriovenous Fistula</subject><subject>Arteriovenous Fistula - etiology</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Kidney Neoplasms - surgery</subject><subject>Nephrectomy</subject><subject>Nephrectomy - adverse effects</subject><subject>Original</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>1677-5538</issn><issn>1677-6119</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNpVUsuO1DAQjBCIXRZ-AZkPyGDnZYcDEox4DFqJA-zZcuz2jkeJHfkxUvhkvgJnZnbFnuzu6qpqtaoo3hG8IW2P3_8iHaVl29Zss_v8425TYdJvMGX9s-L6BHWE9M8v_3XsqngVwgHjqseUvCyu6ho3tK_wdfF3OxprpBiRFjI6H1Dci4iM1WMCKyGXgJyUyftT6TQKyzRHN4loJJoDJOWEheSXMAUkrELCR_DGHcG6FJA2IaZRZEjnNpozarKbhXnvITtOywc0pTGa0tgQTUzROJsHMkstq132XbdLVq4IcilKN8GDnrOAFhD-tBiMWdEc4bJCpsE0uNH8ESv1dfFCizHAm8t7U9x9_fJ7-728_fltt_10W8q2YrHUHSMYNCGDUpipijV1pSQbpCCkJazrdSNqCUNNB4HrgSo5yIrqdlBtBQC0vil2Z918mAOfvZmEX7gThp8azt_z9QhyBN50glLW4WwMDZG9IKyXqmmUaFjV10PW-njWmtMwgZJgoxfjE9GniDV7fu-OnFJSUYyzQH8WkN6F4EE_cgnma5h4WFPC15RwMxwSX8PE1zBl7tv_zR-ZD-mp_wFHDdK_</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Lee, Chan Ho</creator><creator>Ha, Hong Koo</creator><creator>Ku, Ja Yoon</creator><creator>Seo, Won Ik</creator><creator>Choi, Seock Hwan</creator><general>Sociedade Brasileira de Urologia</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-7750-6806</orcidid></search><sort><creationdate>20210101</creationdate><title>Clinical factors that influence the occurrence of symptomatic pseudoaneurysms and arteriovenous fistulas after partial nephrectomy: multi-institutional study of renal function outcomes after one year of selective arterial embolization</title><author>Lee, Chan Ho ; Ha, Hong Koo ; Ku, Ja Yoon ; Seo, Won Ik ; Choi, Seock Hwan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-f6810ef11bdd08d28432dc8bca1151869f4a3ceb37ba03b7dcbc27f5bd52eee73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aneurysm, False</topic><topic>Aneurysm, False - etiology</topic><topic>Arteriovenous Fistula</topic><topic>Arteriovenous Fistula - etiology</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Kidney Neoplasms - surgery</topic><topic>Nephrectomy</topic><topic>Nephrectomy - adverse effects</topic><topic>Original</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Chan Ho</creatorcontrib><creatorcontrib>Ha, Hong Koo</creatorcontrib><creatorcontrib>Ku, Ja Yoon</creatorcontrib><creatorcontrib>Seo, Won Ik</creatorcontrib><creatorcontrib>Choi, Seock Hwan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>International Brazilian Journal of Urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Chan Ho</au><au>Ha, Hong Koo</au><au>Ku, Ja Yoon</au><au>Seo, Won Ik</au><au>Choi, Seock Hwan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical factors that influence the occurrence of symptomatic pseudoaneurysms and arteriovenous fistulas after partial nephrectomy: multi-institutional study of renal function outcomes after one year of selective arterial embolization</atitle><jtitle>International Brazilian Journal of Urology</jtitle><addtitle>Int Braz J Urol</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>47</volume><issue>1</issue><spage>149</spage><epage>158</epage><pages>149-158</pages><issn>1677-5538</issn><eissn>1677-6119</eissn><abstract>Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function.
Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated.
Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p <0.05). In the multivariate analysis, higher N component scores were associated with the occurrence of RAPs/AVFs (Odds ratio: 1.96, p=0.039). In the SAE group, the mean 3-day postembolization eGFR was significantly lower than the mean 3-day postoperative eGFR (p <0.01). This difference in the eGFRs was still present 1 year later.
Renal tumors located near the renal sinus and collecting system were associated with a higher risk for RAPs/AVFs after PN. Although SAE was an effective method for controlling symptomatic RAPs/AVFs after PN, a procedure-related impairment of renal function after SAE could occur and still be present at the end of the first postoperative year.</abstract><cop>Brazil</cop><pub>Sociedade Brasileira de Urologia</pub><pmid>33047920</pmid><doi>10.1590/S1677-5538.IBJU.2019.0789</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7750-6806</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aneurysm, False Aneurysm, False - etiology Arteriovenous Fistula Arteriovenous Fistula - etiology Glomerular Filtration Rate Humans Kidney Neoplasms - surgery Nephrectomy Nephrectomy - adverse effects Original Retrospective Studies Treatment Outcome |
| title | Clinical factors that influence the occurrence of symptomatic pseudoaneurysms and arteriovenous fistulas after partial nephrectomy: multi-institutional study of renal function outcomes after one year of selective arterial embolization |
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