Abstract Background Renal emergencies represent a major subset of acute urological and radiological presentations, encompassing both non-vascular and vascular aetiologies. Vascular renal emergencies such as ruptured angiomyolipoma (AML), post-traumatic, and iatrogenic vascular injuries may cause life-threatening haemorrhage requiring prompt intervention. Super-selective renal artery embolization (SRAE) has emerged as a minimally invasive, nephron-sparing technique for effective haemorrhage control. Few studies have evaluated the clinical outcomes of SRAE in management of emergency renal haemorrhage. So, this study aimed to evaluate the efficacy and clinical outcomes of SRAE in patients presenting with emergency renal haemorrhage of various causes. Methods This prospective observational study was conducted at the Urology and Nephrology Center, Mansoura University, Egypt, from November 2021 to December 2024. A total of 50 patients required transcatheter renal artery embolization. Clinical, laboratory, and radiological assessments were performed pre- and post-procedure. Embolization was achieved using microcoils, microspheres, or a combination of embolic agents. Follow-up imaging and laboratory evaluations were conducted to assess haemostasis, reduction in AML size, and renal function preservation. Results The mean age of the 50 patients was 45.3 ± 15.5 years; males constituted 66%. The most common indications were iatrogenic post-percutaneous nephrolithotomy (PCNL) bleeding (48%), sporadic AML (20%), and tuberous sclerosis-associated AML (12%). Pseudoaneurysm was the predominant vascular lesion (48%). Technical and clinical success rates were 100% and 94%, respectively. AML size and haemorrhage significantly decreased post-embolization ( p < 0.01), with haemoglobin recovery ( p < 0.001). Minor complications occurred in 30%, mainly post-embolization syndrome (16%) and puncture site haematoma (10%). Conclusion SRAE is an effective, safe, and nephron-sparing intervention for managing renal vascular emergencies, offering high success rates and acceptable complication profiles.
El-Hendy et al. (Sat,) studied this question.