Renal balloon occlusion catheter

Renal artery aneurysms can also be seen in patients with angiomyolipomas (AMLs) (Fig. 8.2). Classically, AMLs occur in elderly females and patients with tuberous sclerosis. The entire lesion can often be embolized in addition to coiling the aneurysms. A combination of coils and PVA or simply ethanol infusion with a balloon occlusion catheter can be performed as definitive treatment or if surgical resection is anticipated. 

If surgical resection is planned, ablation of entire lobar or main renal arteries can be performed with ethanol. This requires the use of a balloon occlusion catheter such as a single lumen Balloon Wedge-Pressure Catheter (Arrow International, Reading, PA) to prevent systemic spread of alcohol. Ethanol ablation should be performed within one or two days of the planned resection. This will help to avoid a prolonged post-embolization syndrome, idiich can be quite uncomfortable for patients and can reduce the risk of abscess formation from the ensuing infarction. 

Bakal et al. [7] described a variation of the balloon occlusion technique. They performed all renal embolizations during selective placement of an occlusion balloon catheter in the distal main renal artery. Estimates of ethanol volume needed for embolization were made by test injecting contrast material during balloon occlusion. After infusion of the ethanol, the balloon was left inflated for 5 min. As the balloon was deflating, gentle suction through the distal endhole of the catheter prevented reflux of... 

FIGURE 4.6 The NeuroFlo device with its dual balloon catheter uniquely designed for partial occlusion of the aorta above and below the origin of the renal arteries. 

In a modification of the technique of Ellman et al., Rabe et al. [22] used an occlusion balloon catheter in eight patients. In this technique, the occlusion balloon is inflated in the main renal artery (Fig. 16.2), and ethanol is injected at a rate of 1 to 5 ml/s. The balloon is kept inflated for 10 s to... 

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