Metachronous renal vein and artery injure after percutaneous nephrostolithotomy

Wang, Chaojun; Chen, Shanwen; Tang, Fuqing; Shen, Bin

doi:10.1186/1471-2490-13-69

Cited by 14 publications

(33 citation statements)

References 12 publications

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“… 4 , 8 The complication of severe bleeding during percutaneous procedures is mainly associated with arterial injuries. 4 , 9 Leaving the nephrostomy catheter in the renal pelvis is an effective method to stop venous bleeding. 9 , 10 However, the tube can occasionally pierce the renal parenchyma and migrate into the renal vein and even into the IVC.…”

Section: Discussionmentioning

confidence: 99%

“… 4 , 9 Leaving the nephrostomy catheter in the renal pelvis is an effective method to stop venous bleeding. 9 , 10 However, the tube can occasionally pierce the renal parenchyma and migrate into the renal vein and even into the IVC. 9 , 10 Several publications have shown rare complications that are related to nephrostomy tube misplacement into the vessel following PCNL.…”

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 However, the tube can occasionally pierce the renal parenchyma and migrate into the renal vein and even into the IVC. 9 , 10 Several publications have shown rare complications that are related to nephrostomy tube misplacement into the vessel following PCNL. 2 , 4 , 5 , 9 , 11 – 15 The data from these publications are summarized in Table 1 .…”

Section: Discussionmentioning

confidence: 99%

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Intravenous misplacement of the nephrostomy catheter following percutaneous nephrostolithotomy: a case report and literature review

et al. 2020

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Intravenous misplacement of the nephrostomy catheter following percutaneous nephrostolithotomy (PCNL) is extremely rare, and little information is available about this complication. Because the patient’s prognosis may be poor, sufficient attention should be paid to early identification and treatment of this complication. We present an uncommon case of a patient with intravenous nephrostomy catheter misplacement after PCNL at our hospital. In our patient, the tip of the nephrostomy catheter was located in the inferior vena cava. It was successfully managed using two-step catheter withdrawal under fluoroscopy, and the percutaneous nephrostomy catheter was able to be withdrawn 7 to 8 cm back into the collecting system in stages with the surgical team on standby. There were no severe complications such as deep vein thrombosis that developed during or after the catheter withdrawal. Patients could be managed conservatively using intravenous antibiotics, strict bed rest, and tube withdrawal using computed tomography (CT) or fluoroscopy guide in most cases combined with information in the literature. Additionally, open surgery could be used as an alternative treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intravenous misplacement of the nephrostomy catheter following percutaneous nephrostolithotomy: a case report and literature review

et al. 2020

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“…Clotting of these venous injuries may occur during the operation and, therefore, the injury may not be evident on nephrostograms performed at the conclusion of the procedure or at follow-up. 8 …”

Section: Discussionmentioning

confidence: 99%

Renal Vein Injury During Percutaneous Nephrolithotomy Procedure

Mahmood

Toffeq

2016

Journal of Endourology Case Reports

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Background: Percutaneous nephrostolithotomy is an important approach for removing kidney stones. Puncturing and dilatation are two mandatory steps in percutaneous nephrolithotomy (PCNL). Uncommonly, during dilatation, the dilators can cause direct injury to the main renal vein or to their tributaries.Case Presentation: A 75-year-old female underwent PCNL for partial staghorn stone in the left kidney. During puncturing and dilatation, renal vein tributary was injured, and the nephroscope entered the renal vein and inferior vena cava, which was clearly recognized. Injection of contrast material through the nephroscope confirms the false pathway to the great veins (renal vein and inferior vena cava). Bleeding was controlled intraoperatively by applying Amplatz sheath over the abnormal tract, the procedure was continued and stones were removed. At the end of the procedure, a Foley catheter was used as a nephrostomy tube and its balloon was inflated inside the renal pelvis and pulled back with light pressure to the lower calix, which was the site of injury to the renal vein tributaries, then the nephrostomy tube was closed; by this we effectively controlled the bleeding. The patient remained hemodynamically stable; antegrade pyelography was done on the second postoperative day, there was distally patent ureter with no extravasation, neither contrast leak to renal vein, and was discharged home at third postoperative day. After 2 weeks, the nephrostomy tube was gradually removed in the operative room, without bleeding, on the next day, Double-J stent was removed.Conclusion: Direct injury and false tract to the renal vein tributaries during PCNL can result in massive hemorrhage, and can be treated conservatively in hemodynamically stable patients, using a nephrostomy catheter as a tamponade.

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“…The nephrostomy tube was withdrawn in stages with the surgical team on standby. The pseudoaneurym was treated with percutaneous embolization successfully [5] .…”

Section: Disussionmentioning

confidence: 99%