Transcatheter renal vein embolization for ACPKD

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K17277
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Osaka Metropolitan University (2022-2023); Osaka City University (2019-2021)
• Principal Investigator: SOHGAWA Etsuji 大阪公立大学, 大学院医学研究科, 研究員 (80572643)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: TRVE / IVR / embolization / ACPKD

Outline of Final Research Achievements

The technical success rate of transcatheter renal vein embolization was 100%, and no plug migration was observed during the perioperative or postoperative period. In the transvenous embolization group, congestion and swelling of the kidney, which occurred immediately after embolization, persisted. After a 3-month course, the degree of atrophy of the embolized kidney was better in the transvenous embolization group with gelatin sponge particles than another group without embolic agent, however, the transarterial embolization group showed the best atrophy. Compensatory hypertrophy of the non-embolized kidney was about 150%, regardless of the embolization method. Furthermore, early death occurred in 30% of the transvenous embolization groups, and retroperitoneal hemorrhage occurred in 30% of the same groups.

Free Research Field

IVR　Embolization　TRVE　TAE

Academic Significance and Societal Importance of the Research Achievements

本研究はACPKDにおけるTAEの合併症を低減する目的で、10例と少数例だが技術的成功は100％であり、AVPの移動は1例もなかったことは意義深いと考える。一方で重篤な合併症が30％発生し、対策が必要と考えられた。血圧上昇や膿瘍形成、炎症反応の遷延などは認めず、術後3日のノルアドレナリン値はコントロールのTAE群よりも高い傾向があった。社会的意義としては、TRVEは実現性と一定の効果はあるが、TAEには及ばない。現在臨床の現場でよく施行されているTAEは塞栓後の腎縮小効果が高く、重篤なものも含む合併症発生率が非常に低く、効果と安全性が証明された。