This angiographic image of a kidney that appears to be smoking is sadly a post-biopsy hemorrhage.
In this arterial parenchymal phase you can clearly see contrast filling the biopsy route in the lower pole of the kidney and a ‘plume’ of contrast extravasation in the perirenal space.
This kind of massive bleeding requiring an intervention after kidney biopsy occurs in less than 1%. [needs citation]
Although unfortunate, in this case the bleeding could luckily be stopped by means of selective catherization en a couple of microcoils.