Complete renal embolization as an alternative to nephrectomy

Purpose: Simple nephrectomy is technically demanding in patients with recur rent inflammation or bleeding. It is also unwise to subject patients in poo r health to the rigors of an extensive operative procedure. We report our e xperience with complete renal embolization as a safe and reliable alternati ve to surgical nephrectomy. Materials and Methods: Eight patients underwent complete renal embolization as an alternative to nephrectomy. Patients were given antibiotics intraven ously before and after embolization. Six patients with indwelling nephrosto my tubes received post-embolization instillation of 80 mg. gentamicin befor e tube removal. Narcotic analgesics were also given as needed for pain cont rol. Post-embolization hospital course was noted. Results: The indications for embolization included hydronephrotic, poorly f unctioning kidneys with pain in 5 cases, and recurrent bleeding from angiom yolipoma, bleeding after percutaneous resection of renal pelvic transitiona l cell carcinoma with metastases and spontaneous renal bleeding after hemod ialysis in 1 each. Embolization was successful in 4 men and 4 women with a mean age of 58.8 years. In 6 patients severe flank pain required narcotic a nalgesics. One patient complained of nausea, 6 had fever and 6 had leukocyt osis. In I case thrombosis of a limb of an aortobifemoral bypass graft requ ired thrombectomy. Median hospital stay was 2.5 days. At a mean followup of 30.6 months presenting symptoms had resolved in all cases without hyperten sion, renal failure or abscess. Conclusions: Complete renal embolization is a viable alternative to nephrec tomy in patients with poorly functioning kidneys who present with pain or b leeding and in those who are poor operative candidates. This procedure is s afe, reliable and minimally invasive with few long-term sequelae, and it is well tolerated.