A novel endoscopic treatment for renal arteriopelvic fistula post-percutaneous nephrolithotomy (PCNL)

Chao, Danny V; Abdulla, Alym; Kim, Soojin; Hoogenes, Jen; Matsumoto, Edward D.

doi:10.1590/s1677-5538.ibju.2014.04.18

Cited by 5 publications

(4 citation statements)

References 12 publications

(12 reference statements)

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“…There is a very rare cause of post-PCNL hematuria because of arteriopelvic fistula (APF). This has not been extensively studied but has been reported to be managed using ureteroscopic localization and fibrin sealant placement at fistula site [11].…”

Section: Resultsmentioning

confidence: 99%

Untitled

2020

Int Arch Urol Complic

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Objectives: To assess post-PCNL causes of hematuria and their best treatment. Subjects and Methods: A total of 112 patients underwent PCNL between February 2016 till date through tract sizes ranging from 22 Fr to 26 Fr. Results: Seven patients out of a total of 24 patients with superior calyceal puncture developed post-PCNL hematuria. Only one patient could be managed conservatively while rest 6 required angiography and angioembolization to control hematuria. Conclusions: Early diagnosis and treatment of post-PCNL hematuria is warranted for a successful postoperative outcome with minimal morbidity.

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Section: Resultsmentioning

confidence: 99%

Untitled

2020

Int Arch Urol Complic

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“…In literature few cases of renal bleeding closure with endourological access 10–12 and one case of extra vascular use of a coil 13 are reported.…”

Section: Resultsmentioning

confidence: 99%

“Endourological closure of a malformative vascular source of bleeding using the VortX 0.018” coil®”

et al. 2020

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Aims: Renal vascular malformations, congenital or acquired, are sometimes challenging for urologists and interventional radiologists to resolve. Arterovenous fistulas and pseudoaneuryms are usually embolized by interventional radiologists, with a low rate of complications. We propose a new endourological/interventional radiology technique to treat a source of arterovenous bleeding coming from a renal calyx in a minimally invasive way. Methods: A combined endourological and interventional radiology procedure is described, using a Flexible Fiberoptic Ureteroscopes to undertake a retrograde intrarenal surgery (RIRS) to identify the source of bleeding; subsequently the VortX Coil® is inserted through a microcatheter to stop the bleeding and the correct position of the VortX coil is evaluated. Furthermore, we made a literature research on Pubmed and Medline to look for similar procedures. Results: In case of a renal bleeding that could not be treated by endovascular way, a combined urological and interventional radiology procedure can be undertaken. We did not find similar endourological and interventional radiology procedure on Pubmed and Medline, so this is the first tecnique of endourological closure of a bleeding point using a coil. Conclusion: From our experience this could be a mininvasive technique to solve renal bleedings coming from a calyx that are not found by endovascular approach. Indeed, in our knowledge, the technique here described is the first that provides the use of an endovascular coil by endourological way in renal vascular malformations.

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“…Also, after stone management via percutaneous nephrolithotomy (PCNL), AV fistulas have been described. The literature reports an incidence of 0.3 up to 8.3% [17,18], with previous ipsilateral renal surgery, higher stone complexity, injury to the renal pelvis, and multiple access tracts further increasing risk [19].…”

Section: Discussionmentioning

confidence: 99%

Renal Arteriovenous (AV) Fistula after High-Grade Blunt Renal Trauma Caused by Traffic Accidents

Deininger,

Törzsök,

Lusuardi

et al. 2023

JCM

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Purpose: To report a series of three patients with traumatic renal AV fistulas after blunt renal laceration. Methods: We retrospectively analyzed the renal trauma cases treated in the Department of Urology of Salzburg University Clinic during a time period of 10 years concerning traumatic AV fistula formation and other clinical parameters. Results: In total, 3 cases of traumatic AV fistula formation were identified in 106 blunt renal trauma patients (2.8%), with a mean age of 39 (17–56) years. All renal traumas were classified as American Association for the Surgery of Trauma (AAST) grade IV. Two patients were primarily treated with ureteral stent; one was managed conservatively. All AV fistulas were diagnosed after a mean time of 7 (1–13) days. Two patients were symptomatic with gross hematuria, and the mean time between trauma and onset of symptoms was 11 (9–13) days. All cases were managed via coil embolization after a mean of 10 (8–13) days. Two patients received a second intervention after a mean of 18 (11–25) days. The mean AV fistula size was 18.7 (12–24) mm. Mean hemoglobin loss was 3.6 g/dL. One patient received one erythrocyte concentrate. Discharge was after a mean time of 13.3 (7–12) days, with the mean time of intensive care treatment being 2.3 (1–3) days. Conclusions: Traumatic renal AV fistula is a rare but severe complication associated with higher-grade renal trauma. It can become evident through hematuria or blood loss several days after the initial trauma. The availability of coil embolization in a trauma center can help kidney preservation management.

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A novel endoscopic treatment for renal arteriopelvic fistula post-percutaneous nephrolithotomy (PCNL)

Cited by 5 publications

References 12 publications

Untitled

Untitled

“Endourological closure of a malformative vascular source of bleeding using the VortX 0.018” coil®”

Renal Arteriovenous (AV) Fistula after High-Grade Blunt Renal Trauma Caused by Traffic Accidents

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