INTRAVENOUS DIGITAL SUBTRACTION ANGIOGRAPHY FOR THE EVALUATION OF RENAL-ARTERY BLOOD-FLOW FOLLOWING THE REMOVAL OF A NEUROBLASTOMA

There have been several reports of acute renal failure following the r esection of an abdominal neuroblastoma combined with ipsilateral nephr ectomy as well as the atrophy or disappearance of an unresected kidney after tumor resection. Spasms or thrombosis of the renal artery durin g tumor excision are considered to be the major cause. Since 1989, int ravenous digital subtraction angiography (IVDSA) has been used to eval uate the renal artery blood flow immediately following surgery in seve n patients with abdominal neuroblastomas. IVDSA was performed using a central venous catheter inserted prior to surgery. In all seven patien ts, IVDSA provided clear images for the evaluation of renal artery blo od flow. In one of the two patients whose kidneys briefly became cyano sed during tumor excision, IVDSA demonstrated an occlusion of the rena l artery and prompt measures could be taken to reestablish the blood f low. No complications of IVDSA occurred in any of the seven patients. IVDSA using a central venous catheter was thus considered to be useful for evaluating the renal artery blood flow in patients with a suspect ed renal artery blood flow disturbance without any risk of complicatio ns, and this modality obviated the need for intraarterial angiography.