ISSN:
1432-2102
Keywords:
Schlüsselwörter Nierentumor
;
Embolisation
;
Niere
;
Angioplastie
;
A. renalis
;
Stents
;
Nierentrauma
;
Blutung
;
Key words Renal carcinoma
;
Tumor embolization
;
Kidney
;
Angioplasty
;
Stent
;
Renal artery
;
Renal trauma
;
Bleeding
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Summary For imaging of renal pathology a broad spectrum of radiologic diagnostic procedures are available which are, sometimes and particularly more recently, competing among each other in their diagnostic yield and relevance. For tumorous lesions ultrasound, computed tomography and magnetic reso-nance imaging are performed predominantly. Angiography is no longer required with the exception of highly selected cases and in some specific preoperative workup requirements. Until recently, catheter based digital subtraction angiography has been consid- ered as gold standard. However, non-invasive techniques such as CT-angiography and MR-angiography are evolving parallel to their quantum leap of resolutions and readiness to use. Nevertheless, well accepted criteria for quality assessement of these new modalities are still lacking. More comparison studies are urgently warranted. Despite the availability of ultrashort pulse sequences applying the T1 relaxation reduction effect of gadolinium enhanced MR techniques overestimation of renal artery stenosis still po-ses a substantial problem. Renal intervention implies a variety of procedures such as plain angioplasty, stent placement, embolization of traumatic and both benign and malignant tumors. These methods have emerged over the last two decades from a more experimental nature to a fully accepted treatment option. When renal artery angioplasty is embedded in an aggressive approach including stenting as an adjunct for more complex cases, renal ostial lesions and a well organized follow-up regimen its therapeutic potential for treatment of renal insufficiency, malignant hypertension, for organ preservation bears a very high potential. Provided adequat periinterventional drug regimen restenosis rates may be as low as 10%. In highly selected cases capillary embolization might be used as an alternative to nephrectomy with a similar clinical outcome. Particularly the development of superselective small caliber embolization catheters parallel to further refinement of embolization material has aided to use superselective occlusion techniques in benign vascular lesions and renal trauma.
Notes:
Zusammenfassung In der Diagnostik von pathologischen Veränderungen der Nieren konkurrieren die Katheterangiographie, der Ultraschall, die Computertomographie und die Kernspintomographie. In der Abklärung renaler Raumforderungen stehen die Schnittbildverfahren heute im Vordergrund. In der Diagnostik von Nierenarterienstenosen ist die Angiographie bis heute der Goldstandard. Die weniger invasiven angiographischen Techniken der CT und der MRT sind in aufwendigen Studien der Angiographie der Nierenarterien ebenbürtig, es mangelt jedoch insbesondere für die immer häufiger zum Einsatz kommende MR-Angiographie an verbindlichen Qualitätskriterien. In der interventionellen Radiologie der Nieren sind die angiographischen Techniken der Nierenarterienangioplastie inklusive der Stentimplantation und die Embolisationstechniken ausgereift. Die klinischen Ergebnisse können gut gegen die der operativen Verfahren bestehen. Die interventionellen Verfahren haben somit ihren festen Platz im Spektrum der modernen minimal invasiven Medizin.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001170050524
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