Although the editors of InsideSurgery.com are not participating in Melania Trump’s care, we have noted with interest news reports that she received a “kidney surgery” today at Walter Reed Hospital.
She reportedly received an embolization for a “benign” condition and will be hospitalized through the end of the week. Some thoughts on this development:
Embolizations are most commonly done through one of the main femoral or groin arteries and it does not require a large incision. Typically a large bore needle with a sheath is placed into the artery by an interventional radiologist and then under flouroscopy an embolization catheter is threaded up towards in the aorta until the renal or kidney artery is reached. The catheter can then be threaded into the renal artery to the area of concern in the kidney.
After the catheter is placed correctly, a coil or foam is placed into the artery blocking the artery and “killing the tissue” beyond the blockage. Sometimes a dye is injected into the body’s arterial system to confirm that dye does not reach beyond the blockage. The catheter and sheath are then removed, with the small hole in the artery closed using a device specially designed to place a suture around the arterial puncture site.
Embolizing tissue in a solid organ is done very commonly by interventional radiologists, most usually to choke off blood supply to a tumor or cancer. However, it is not usually the first procedure done when a cancer that can be removed surgically is present, as are most kidney cancers. It can be done to “kill tissue” that is forming a cyst.
Generally embolizations for a small amount of benign tissue or a small cyst would not require a post-op stay of 3-4 days. The treating team in this case will likely be checking her kidney function using creatinine and BUN (blood urea nitrogen) and will be watching the puncture site to detect any development of pseudoaneurysm.
However, there is much that is left out of today’s report that would be helpful to know to fully ascertain the condition and care Mrs. Trump has received.