Renal artery embolisation before a nephrectomy, explained | CION Cancer Clinics

Renal artery embolisation blocks the main blood vessel feeding a kidney tumour, a day or so before the operation to remove the kidney. It is done through a thin tube passed up an artery from the groin or wrist, not through a cut in the belly.

Why a surgeon might ask for it

Some kidney tumours are large and carry a thick web of blood vessels. Blocking the supply first can make the kidney softer and less likely to bleed heavily when the surgeon works around it. The operation that follows is called a nephrectomy, which simply means removing the kidney, either whole (radical) or in part (partial).

It is not a routine step

Most people who have a kidney removed for cancer never have this procedure. Studies comparing surgery with and without it are small and mostly look back at past patients, and they do not show a clear benefit for everyone. Many surgeons now keep it for a few difficult situations rather than using it by habit. If it has been suggested for you, it is fair to ask what it adds in your case.

Most people feel unwell for a short time. Once the kidney loses its blood supply, the tissue starts to die, and the body reacts to that. The reaction is called post-infarction syndrome, which means the symptoms that follow when an organ loses its blood supply.

What that feels like

Pain in the side or back, a fever, feeling sick and a general sense of being unwell are all common. Pain relief and anti-sickness medicine are given on the ward. This is one reason the operation is often planned soon after the embolisation rather than weeks later.

Why the timing is kept short

Once the main artery is blocked, the body starts to grow small new vessels around the kidney, and the effect wears off over time. The surgeon and radiologist agree the gap together. Your team will tell you the plan for your own case, and it can change if you are unwell.

Who it does not suit

It is used with more caution in people with poor function in the other kidney, a serious reaction to contrast dye before, or bleeding problems that cannot be corrected.

This page cannot tell you whether you should have embolisation before your surgery. That decision belongs to your surgeon and radiologist, who have seen your scans. What it can do is help you ask good questions.

Questions worth asking

Ask what the embolisation is meant to achieve in your case, and what would happen if it were skipped. Ask who will do it, and how long the gap before surgery will be. Ask what pain relief is planned for the reaction afterwards, and whether the extra procedure changes the total bill or what your scheme covers.

It says nothing about the outlook

Whether or not you have this procedure tells you nothing about how the cancer will behave. That depends on the type of kidney cancer, its stage, which means how far it has spread, and what the pathology report shows after the kidney is removed.