Owing to improvements in
catheters and embolic
agents, renal artery embolization (RAE) is increasingly used to treat nephrological and
urological disease. RAE has become a useful adjunct to medical
resuscitation in severe penetrating, iatrogenic or blunt renal traumatisms with active
bleeding, and might avoid surgical intervention, particularly among patients that are haemodynamically stable. The role of RAE in pre-operative or palliative management of advanced malignant renal tumours remains debated; however, RAE is recommended as a first-line
therapy for
bleeding angiomyolipomas and can be used as a preventative treatment for
angiomyolipomas at risk of
bleeding. RAE represents an alternative to
nephrectomy in various medical conditions, including severe uncontrolled
hypertension among patients with
end-stage renal disease, renal graft intolerance syndrome or
autosomal dominant polycystic kidney disease. RAE is increasingly used to treat renal artery
aneurysms or symptomatic renal
arteriovenous malformations, with a low complication rate as compared with surgical alternatives. This Review highlights the potential use of RAE as an adjunct in the management of renal disease. We first compare and contrast the technical approaches of RAE associated with the various available embolization agents and then discuss the complications associated with RAE and alternative procedures.