Endovascular management of hemorrhagic complications after percutaneous nephrolithotomy: 10-years experience

Roca, A. Alabat; Torrecilla, Carlos; Freixa, Sergi C.F. Colom; Campaña, José María Cuadrado; Beato, Sílvia; Riera, Lluı́s; Julià, F. Vigués

doi:10.1016/s2666-1683(20)33281-x

Cited by 1 publication

(8 citation statements)

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“…Mean interval time between PCNL and arteriography and selective embolization was 7 days. They concluded that rapid detection and treatment of post PCNL vascular injuries with arteriography and selective embolization is an effective and minimally invasive method 1 …”

Section: Discussionmentioning

confidence: 99%

“…They concluded that rapid detection and treatment of post PCNL vascular injuries with arteriography and selective embolization is an effective and minimally invasive method. 1 In another study, Anand et al evaluate hematuria causes after PCNL and their best treatment. In their study, 8.3% of patients had AVF.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous nephrolithotomy (PCNL) is a common treatment for large kidney stones 1 . However, it is reported that renal hemorrhage and vascular injury is the most complicated after PCNL with incidence rate of 11.2%–17.5% 2,3 .…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Vascular injuries occur due to renal punctures that can be resolved by its own or lead to pseudoaneurysm (PA) and arteriovenous fistula (AVF) that needs to be detected and managed early. 1,4,5 Based on previous studies, diagnosis of vascular injuries is based on CT angiogram. 5 On the other hand, it is shown that transcatheter arterial embolization is a safe and effective treatment that is used after detection of vascular injury with CT angiogram.…”

Section: Introductionmentioning

confidence: 99%

“…Percutaneous nephrolithotomy (PCNL) is a common treatment for large kidney stones. 1 However, it is reported that renal hemorrhage and vascular injury is the most complicated after PCNL with incidence rate of 11.2%–17.5%. 2 , 3 Vascular injuries occur due to renal punctures that can be resolved by its own or lead to pseudoaneurysm (PA) and arteriovenous fistula (AVF) that needs to be detected and managed early.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular management of post PCNL vascular injuries

Salimi

SiahkalMahalleh

Yazdi

2023

Clinical Case Reports

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Key Clinical MessageAlthough percutaneous nephrolithotomy (PCNL) is a gold standard treatment of large kidney stones, vascular injuries like pseudoaneurysm (PA) and arteriovenous fistula (AVF) may occur due to renal punctures. These endovascular complications need urgent intervention to be diagnosed and managed early. In this case series, 14 patients who had hematuria after PCNL were managed by using angiography to identify the vascular pathology. Among them, we identified 10 patients with PA and 4 patients with AVF, 1 patient with both subscapular hematoma and PA. Angiographic embolization was done successfully in all patients. Based on our results, in cases with peripheral parenchymal damage, PA was common and in cases with hilar damage, AVF was common. No other complication and rebleeding was detected after embolization. Based on our study, angiography can be used as a safe and effective method to detect and treat vascular injuries immediately and successfully.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%