Intrarenal pseudoaneurysm after percutaneous nephrolithotomy: angiotomographic assessment and endovascular management

Massulo-Aguiar, M. F.; Campos, Christiane Monteiro de Siqueira; Rodrigues-Netto, N

doi:10.1590/s1677-55382006000400009

Cited by 13 publications

(10 citation statements)

References 3 publications

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“…Selective renal embolization is currently considered the most appropriate technique in the treatment of these complications, with a success rate greater than 80% and a low complication rate [1]. Pseudoaneurysms must be occluded with a permanent agent at the fistulous point where the risk of hemorrhage is greater [2]. …”

Section: Discussionmentioning

confidence: 99%

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Glued Angiocatheter: A Rare Complication of Intrarenal Pseudoaneurysm Glue Angioembolization

et al. 2014

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Endovascular management of intraparenchymal renal artery pseudoaneurysms is a reasonable and effective therapeutic technique. Endovascular management preserves the maximum amount of renal tissue and reduces the potential risk of nephrectomy. We present the case of an angiocatheter that became stuck in the renal artery following the injection of cyanoacrylate glue for angioembolization of an intrarenal pseudoaneurysm.

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Section: Discussionmentioning

confidence: 99%

“…Cyanoacrylate glue (NBCA) is a lasting and efficient occluding agent that has been successfully used for more than 20 years [2]. The polymerization time of NBCA can be delayed by adding iodized oil.…”

Section: Discussionmentioning

confidence: 99%

Glued Angiocatheter: A Rare Complication of Intrarenal Pseudoaneurysm Glue Angioembolization

et al. 2014

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“…Angiography has emerged as the standard but multiple non-invasive tests, such as renal ultrasound, intravenous pyelography, contrast-enhanced CT scanning (with three dimensional reconstruction), magnetic resonance imaging and renal scintigraphy, have been used with moderate success in diagnosing renal artery pseudoaneurysm [8]. The advantages of angiography in this setting include high sensitivity in identifying the PA (which usually appears as a round or oval structure arising from the main renal artery or one of its branches) and the potential to achieve simultaneous endovascular management of these lesions, with success rates exceeding 90% [3].…”

Section: Discussionmentioning

confidence: 99%

“…Superselective embolisation is highly efficient in achieving PA occlusion through the injection of a permanent agent at the fistulous point. Materials such as ethanol, gel foam particles and N-butyl-2-cyanoacrylate [3,7,8] have been successfully used for embolisation. However, embolisation for the management of PA does have some shortcomings, such as possible reflux of embolic material into the normal proximal vessel if the distal branch has not been selectively cannulated and the risk of more generalised ischemia resulting from thrombosis of a main feeding branch [9].…”

Section: Discussionmentioning

confidence: 99%

Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report

et al. 2010

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IntroductionIntrarenal pseudoaneurysm is a rare, yet clinically significant, complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order to recognize pseudoaneurysm as the cause of delayed bleeding after percutaneous nephrolithotomy and angiography confirms the diagnosis which allows endovascular management.Case presentationWe present a case of a 65-year old Caucasian woman who underwent percutaneous nephrolithotomy in the supine position for a two centimetre renal calculus. The postoperative course was complicated by persistent bleeding due to a renal pseudoaneurysm. The vascular lesion was successfully managed by endovascular exclusion through the use of a covered stent graft. We report the first successful use of this method for the management of iatrogenic pseudoaneurysm in a branch of the left renal artery and we focus on the imaging findings, technical details, advantages and limitations of this technique.ConclusionAs a result of its high efficacy, interventional radiology has largely replaced open surgery for the management of renal pseudoaneurysm related to percutaneous nephrolithotomy. Recent technical advancements have allowed the use of covered stent grafts as an alternative to embolisation for the angiographic management of visceral artery pseudoaneurysm located in other organs. This novel technique allows the endovascular exclusion of the pseudoaneurysm, without compromising arterial supply to the end-structures - an advantage of critical importance in organs supplied by segmental arteries - in the absence of collateral vasculature, such as the kidney.

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“…The reported incidence of renal pseudo aneurysm following PCNL is 0.6–1%. [3] In less severe cases, bleeding arises from the venous channels or an infection of necrosed parenchymal tissue. Venous bleeding can usually be managed conservatively because the intrarenal venous system is quite resilient;[1] whereas, arterial bleeding needs to be embolized.…”

Section: Discussionmentioning

confidence: 99%

Emerging role of multi-detector computed tomography in the diagnosis of hematuria following percutaneous nephrolithotomy: A case scenario

Sivanandam¹,

Mathew²,

Bhat³

2009

Indian J Urol

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Persistent hematuria is one of the most dreaded complications following percutanous nephrolithotomy (PCNL). Although invasive, a catheter-based angiogram is usually used to localize the bleeding vessel and subsequently embolize it. Advances in imaging technology have now made it possible to use a non invasive multi-detector computed tomography (MDCT) angiogram with 3-D reconstruction to establish the diagnosis. We report a case of post-PCNL hemorrhage due to a pseudo aneurysm that was missed by a conventional angiogram and subsequently detected on MDCT angiogram.

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Intrarenal pseudoaneurysm after percutaneous nephrolithotomy: angiotomographic assessment and endovascular management

Cited by 13 publications

References 3 publications

Glued Angiocatheter: A Rare Complication of Intrarenal Pseudoaneurysm Glue Angioembolization

Glued Angiocatheter: A Rare Complication of Intrarenal Pseudoaneurysm Glue Angioembolization

Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report

Emerging role of multi-detector computed tomography in the diagnosis of hematuria following percutaneous nephrolithotomy: A case scenario

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