Images from left renal arteriography. DSA images of left renal show that the upper left renal artery (A) and bottom left renal artery (B) provides blood for upper pole and bottom pole of left renal, respectively. 

Contexts in source publication

Context 1

... informed consent was obtained from the patient and his immediate family members, digital subtraction angiography (DSA, OEC9800 C-arm X-ray system, GE, USA) of bilateral renal arteries was performed through right femoral artery using a 6F, 40-cm Flexor Check-Flo sheath and 5F Cobra catheter (Cook Medical, Bloo- mington, IN). For the first subtraction angiography of right renal artery, no signs of renal artery renal hemorr- hage were found and the renal artery system seems intact for the right renal (Figure 2(A)). However, an obvious severe bleeding from the inferior right accessory renal artery at the lower pole of the right renal was found (Figure 2(B)). After the application of the accessory renal artery embolization with gelatin sponge particles and two fibered platinum coils, bleeding was stopped indicated by subtraction angiography (Figure 2(C)) and he- moglobin returned to normal in 7 days after surgery. Furthermore, the DSA images showed that the left renal has also double renal arteries origin from the descending aorta (Figure 3(A) and Figure ...

Context 2

... informed consent was obtained from the patient and his immediate family members, digital subtraction angiography (DSA, OEC9800 C-arm X-ray system, GE, USA) of bilateral renal arteries was performed through right femoral artery using a 6F, 40-cm Flexor Check-Flo sheath and 5F Cobra catheter (Cook Medical, Bloo- mington, IN). For the first subtraction angiography of right renal artery, no signs of renal artery renal hemorr- hage were found and the renal artery system seems intact for the right renal (Figure 2(A)). However, an obvious severe bleeding from the inferior right accessory renal artery at the lower pole of the right renal was found (Figure 2(B)). After the application of the accessory renal artery embolization with gelatin sponge particles and two fibered platinum coils, bleeding was stopped indicated by subtraction angiography (Figure 2(C)) and he- moglobin returned to normal in 7 days after surgery. Furthermore, the DSA images showed that the left renal has also double renal arteries origin from the descending aorta (Figure 3(A) and Figure ...

Context 3

... interest issue in this case is the anatomical variations of renal vascular. Although accessory renal arteries are the most common renal vascular variant and are seen in about one-third of the population, bilateral double renal arteries are seldom and can be detected through multidetector CT angiography, DSA and necropsy by chance [8] [9]. As Figure 3 demonstrated, most double renal arteries provides blood to different lobe of renal and "filling defect" sign was clearly in DSA images [10]. In the current case, "filling defect" sign is not availa- ble in the DSA image because the upper right renal artery provides blood for most of right renal. We have learned from this case that it necessary that find accessory renal artery to eliminated the possible of artery he-morrhage if the "filling defect" sign is not clear. Whole aortic DSA imaging by using a pigtail catheter before or after the super-selective renal artery DSA imaging may help to diagnosis the accessory renal artery bleeding, if it is not available for the sign of renal artery bleeding post-PCNL in the DSA procession. It is expected that our case will provide important insight for clinic interventional radiologist, particularly for early-career interven- tional radiologist in treatment of renal hemorrhage ...