Early postoperative screening by contrast-enhanced CT and prophylactic embolization of detected pseudoaneurysms prevents delayed hemorrhage after partial nephrectomy

J Vasc Interv Radiol. 2015 Jul;26(7):950-7. doi: 10.1016/j.jvir.2015.02.023. Epub 2015 Apr 14.


Purpose: To evaluate retrospectively whether prophylactic embolization of pseudoaneurysms detected on early postoperative screening with computed tomography (CT) after partial nephrectomy can prevent delayed hemorrhage.

Materials and methods: Between January 2012 and May 2014, early postoperative contrast-enhanced CT was performed 3-5 days after partial nephrectomy in 312 patients (group A); CT was not performed in 65 patients (group B) because of renal insufficiency or contrast medium allergy. If pseudoaneurysms were detected on CT in group A, prophylactic embolization was performed. The frequency of delayed hemorrhage occurring more than 3 days after surgery in group A was compared with group B and with 212 patients (group C) who underwent partial nephrectomy between January 2010 and December 2011 without early postoperative CT. Changes in estimated glomerular filtration rate at discharge were compared among the groups.

Results: Prophylactic embolization of pseudoaneurysms was performed in 26 patients (8%) in group A. Frequency of delayed hemorrhage in group A (0.6%) was significantly lower than in groups B (4.6%; P = .038) and C (4.7%; P = .005). No major complications attributable to prophylactic embolization were observed. The decrease in estimated glomerular filtration rate in group A (-2% ± 13%) was smaller than that in group B (-8% ± 13%; P < .001) and not worse than that in group C (-4% ± 14%; P = .108).

Conclusions: Prophylactic embolization of pseudoaneurysms detected on early postoperative CT can prevent delayed hemorrhage after partial nephrectomy, without major complications.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, False / diagnostic imaging*
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy*
  • Contrast Media*
  • Early Diagnosis
  • Embolization, Therapeutic* / adverse effects
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Nephrectomy / adverse effects*
  • Postoperative Hemorrhage / diagnosis
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / prevention & control*
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult


  • Contrast Media