Renal pseudoaneurysm following laser lithotripsy: Endovascular treatment of a rare complication

Watanabe, Moe; Padua, Horacio; Nguyen, Hiep T.; Alomari, Ahmad I.

doi:10.1016/j.jpurol.2009.12.011

Cited by 10 publications

(6 citation statements)

References 14 publications

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“…The patient was finally diagnosed with renal pseudoaneurysm after poor response to antibiotic treatment. Watanabe et al [ 15 ] described the case of a postrenal transplantation patient who developed gross hematuria 2 days after laser lithotripsy for stones in an allograft renal pelvis and lower calyx.…”

Section: Discussionmentioning

confidence: 99%

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Renal pseudoaneurysm after rigid ureteroscopic lithotripsy: A case report

Li¹,

Lin²,

Hsu³

et al. 2022

WJCC

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BACKGROUND Ureteroscopic lithotripsy (URSL) is a common surgical treatment for ureteral stones. Although flexible ureteroscopy can be used to treat ureteral and renal stones in a single procedure, rigid ureteroscopy can only be used to treat ureteral stones; nonetheless, rigid ureteroscopy remains mainstream in Taiwan owing to its late introduction and flexible ureteroscopy is not covered by national health insurance. Hematuria is a common complication that occurs when the scope passes through stricture sites or when mucosal damage occurs during lithotripsy, but this is usually self-limited. Prolonged hematuria requiring intervention is termed persistent hematuria. Persistent hematuria is less common and few studies have reported the development and etiology of renal pseudoaneurysm after flexible ureteroscopy for renal stones. Herein, we present the first reported case of renal pseudoaneurysm after rigid URSL for ureteral stone. CASE SUMMARY The patient was a 57-year-old man who developed renal pseudoaneurysm with active bleeding after rigid ureteroscopy. He presented with gross hematuria and intolerable left flank pain after left URSL. Severe anemia was noted (hemoglobin level, 6.8 g/dL). Contrast enhanced computed tomography revealed one pseudoaneurysm each in the upper and lower renal cortex. He was managed via transcatheter arterial embolization with microcoils, which relieved the symptoms. CONCLUSION To the best of our knowledge, ours is the first case report on renal pseudoaneurysm after rigid URSL. Because renal pseudoaneurysms are difficult to access, underlying hypertension, clinical signs such as refractory flank pain, and gross hematuria should be carefully monitored following similar endourological procedures.

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Section: Discussionmentioning

confidence: 99%

“…In the five patients described above[ 11 - 15 ], no intraoperative complications were recorded; however, three patients presented with delayed bleeding after postoperative day 19. The vessel of the grafted kidney was considered to be weaker than that of the native kidney and was sensitive to intrarenal pressure changes.…”

Section: Discussionmentioning

confidence: 99%

Renal pseudoaneurysm after rigid ureteroscopic lithotripsy: A case report

Li¹,

Lin²,

Hsu³

et al. 2022

WJCC

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“…They occur in both men and women but the incidence of rupture is higher in women, especially if they are pregnant. Renal artery pseudoaneurysm has been reported as a result of blunt trauma 2 or deceleration 3 injury and following urological interventions such as partial nephrectomy, 4 percutaneous nephrolithotomy, 5 renal biopsy, 6 ureterorenoscopy for laser lithotripsy 7 and following renal transplantation. 8 Our case was unusual as there was no predisposing event associated with the renal artery pseudoaneurysm and subsequent rupture.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of a renal artery pseudoaneurysm with no precipitating risk factor

et al. 2018

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“…14 Embolization of RAP has been reported to have high success rates exceeding 90%. 4,[14][15][16][17] The risk of rupture is estimated to be low, but is associated with a death rate as high as 80%. 18 Currently, no definite guidelines exist for the size at which an RAP should be repaired in an asymptomatic patient.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Spontaneous Asymptomatic Renal Artery Pseudoaneurysm Treated with Coil Embolization: A Case Report

Chataut

Maharjan

Panta

et al. 2017

J Clin Interv Radiol ISVIR

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Background Renal artery pseudoaneurysm (RAP) is a rare renal vascular abnormality but a life-threatening condition that requires multiple imaging modalities for diagnosis and successful management. It can occur as a complication associated with a percutaneous renal biopsy procedure, renal surgery, and trauma. Asymptomatic spontaneous RAP is also a rare entity and not reported in literature. Case Presentation A 28-year-old patient presented to the outpatient department for ultrasound of the breast for mastalgia and routine ultrasound of the abdomen. Ultrasound breast was normal; however, a cystic lesion with color uptake with a yin–yang pattern and to-and-fro spectral waveform was seen in the lower pole of left kidney suggesting a pseudoaneurysm. A computed tomography renal angiogram confirmed the diagnosis. The patient was completely asymptomatic with no history of any renal surgery or intervention or any trauma to the abdomen. Her general and systemic examinations were unremarkable. Digital subtraction angiography and coil embolization of the pseudoaneurysm were performed. Absent of flow in the lesion was demonstrated in postembolization angiography images and ultrasound images. Conclusion RAP has always been described in patients after renal biopsy, surgery, interventions, or trauma. However, we present a case of asymptomatic spontaneous RAP, which was incidentally discovered and effectively treated with coil embolization.

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Renal pseudoaneurysm following laser lithotripsy: Endovascular treatment of a rare complication

Cited by 10 publications

References 14 publications

Renal pseudoaneurysm after rigid ureteroscopic lithotripsy: A case report

Renal pseudoaneurysm after rigid ureteroscopic lithotripsy: A case report

Spontaneous rupture of a renal artery pseudoaneurysm with no precipitating risk factor

A Rare Case of Spontaneous Asymptomatic Renal Artery Pseudoaneurysm Treated with Coil Embolization: A Case Report

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