Jornal Vascular Brasileiro
http://www.jvb.periodikos.com.br/article/doi/10.1590/1677-5449.202502011
Jornal Vascular Brasileiro
Therapeutic Challenge

Manejo endovascular do trauma renal grave: desafio terapêutico

Endovascular management of severe renal trauma: a therapeutic challenge

Isabela Zampirolli Leal; Renato da Silva Galvão; Gabriela de Oliveira Buril; Daniel Duarte Rolim; Carlos Castanha de Albuquerque Neto; Alexandre José de Souza Guedes; Leucio Barros Verás Filho; Ítalo Emmanuel Lima Ferreira

Downloads: 0
Views: 5

Resumo

O trauma renal grave é uma condição rara e potencialmente fatal que requer abordagem rápida e individualizada. A embolização seletiva tem se mostrado uma alternativa eficaz e minimamente invasiva para o controle do sangramento e preservação da função renal. Apresentam-se dois casos de trauma renal grave, um contuso e outro penetrante, tratados com sucesso por embolização superseletiva. No primeiro, utilizaram-se micromolas para oclusão de ramos segmentares; no segundo, aplicou-se cola (Hystoacryl + Lipiodol) a 33%. Ambos os pacientes evoluíram com estabilização hemodinâmica, recuperação laboratorial e preservação funcional do rim afetado, sem complicações. O tratamento endovascular mostrou-se seguro e determinante para evitar a nefrectomia, destacando o papel da radiologia intervencionista como ferramenta essencial no manejo dos traumas renais de alta complexidade.

Palavras-chave

trauma renal; embolização terapêutica; radiologia intervencionista; procedimentos endovasculares

Abstract

Severe renal trauma is a rare and potentially life-threatening condition that requires rapid and individualized management. Selective embolization has proven to be an effective and minimally invasive option for hemorrhage control and renal function preservation. We present two cases of severe renal trauma, one blunt and one penetrating, successfully treated with superselective embolization. In the first case, microcoils were used for segmental branch occlusion; in the second, cyanoacrylate glue (Hystoacryl + Lipiodol, 33%) was applied. Both patients achieved hemodynamic stabilization, laboratory recovery, and preserved renal function without complications. Endovascular management proved to be a safe and decisive treatment, avoiding nephrectomy and reinforcing the essential role of interventional radiology in the management of high-complexity renal trauma.

Keywords

renal trauma; therapeutic embolization; interventional radiology; endovascular procedures

References

1 Coccolini F, Moore EE, Kluger Y, et al. Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 2019;14(1):54. https://doi.org/10.1186/s13017-019-0274-x. PMid:31827593.

2 Smith TA, Eastaway A, Hartt D, Quencer KB. Endovascular embolization in renal trauma: a narrative review. Ann Transl Med. 2021;9(14):1198. https://doi.org/10.21037/atm-20-4310. PMid:34430639.

3 Rossi UG, Cariati M. Blunt renal artery trauma: a therapeutic dilemma. Turk J Urol. 2018;45(3):233-6. https://doi.org/10.5152/tud.2018.91145. PMid:31846422.

4 Contegiacomo A, Amodeo EM, Cina A, et al. Renal artery embolization for iatrogenic renal vascular injuries management: 5 years’ experience. Br J Radiol. 2020;93(1106):20190256. https://doi.org/10.1259/bjr.20190256. PMid:31794248.

5 Öcal O, Puhr-Westerheide D, Mühlmann M, et al. iRESCUE - Interventional embolization of Renal arteries after SurgiCal or traUmatic injury with hemorrhage. Eur J Radiol. 2021;136:109540. https://doi.org/10.1016/j.ejrad.2021.109540. PMid:33476964.

6 Kopačin V, Turk T, Pavlović O, Perković J, Krajina V, Pavoković D. The role of interventional radiologists in the treatment of complications in urologic patients. Acta Clin Croat. 2023;62(Suppl 2):153-7. https://doi.org/10.20471/acc.2023.62.s2.23. PMid:38966013.

7 Jardinet T, Bonne L, Oyen R, Maleux G. Initial experience with the microvascular plug in selective renal artery embolization. Vasc Endovascular Surg. 2020;54(3):240-6. https://doi.org/10.1177/1538574419897500. PMid:31928203.

8 Góes AMO, Parreira JG, Kleinsorge GHD, et al. Brazilian guidelines on diagnosis and management of traumatic vascular injuries. J Vasc Bras. 2023;22:e20230042. https://doi.org/10.1590/1677-5449.202300422. PMid:38021277.

9 Wang B, Wen C, Song S, et al. Safety and efficacy of Endovascular Management of high-grade blunt renal injury. J Interv Med. 2022;5(1):23-7. https://doi.org/10.1016/j.jimed.2021.12.003. PMid:35586283.

10 Xu H, Min X, Li Y, Yang L, Ren Y. A comparative study of conservation, endovascular embolization therapy, and surgery for blunt renal trauma. Med Sci Monit. 2020;26:e922802. https://doi.org/10.12659/MSM.922802. PMid:32372763.

11 Lopez-Gonzalez DB, Zurkiya O. Interventional radiology in renal trauma. Semin Intervent Radiol. 2021;38(1):113-22. https://doi.org/10.1055/s-0041-1726006. PMid:33883808.

12 Piasecki P, Ząbkowski T, Brzozowski K, et al. The assessment of the risk of acute kidney injury in patients undergoing an urgent endovascular treatment due to severe renal bleeding. Cardiovasc Intervent Radiol. 2018;41(3):398-405. https://doi.org/10.1007/s00270-017-1800-4. PMid:29038877.

13 Sgalambro F, Giordano AV, Carducci S, et al. The role of interventional radiology in hepatic and renal hemorrhage embolization: single center experience and literature review. Acta Biomed. 2021;92(S5):e2021405. PMid:34505844.
 


Submitted date:
11/06/2025

Accepted date:
04/22/2026

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
6a592ac7a953956d1673a584 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections