Endovascular Management of Post-PCNL Vascular Injuries

Salimi J1, Siahkalmahalleh MR2 and Yazdi SAM3*

1Department of Vascular and Endovascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Iran
2School of Medicine, Tehran University of Medical Sciences, Iran
3Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Iran

^*Correspondance to: Seyed Amir Miratashi Yazdi 

 PDF  Full Text DOI: 10.25107/2474-1647.3554

Abstract

Introduction: Although PCNL is gold standard treatment for large kidney stones; vascular injuries like Pseudoaneurysm (PA) and Arteriovenous Fistula (AVF) may occur due to renal punctures that need to be detect and manage early. In this study we aimed to evaluate the use of angiography in the detection and management of renal vascular injuries after PCNL and the efficacy of this management. Material and Method: In this prospective study, all patients who underwent endovascular management to identify the vascular pathology after PCNL at Sina Hospital were evaluated. Embolization with coil was done for all of them. The follow-up included clinical findings especially hematuria, as well as ultrasonography when necessary to detect any collection. Results: Among 14 patients with post-PCNL vascular injury, we identified 10 patients with PA and 4 patients with AVF, 1 patient with both subscapular hematoma and PA. Angiographic embolization was successful in all patients. In cases that parenchymal damage was in peripheral region, the common complication was PA and when the damage was in the hilar region, complication was AVF. No any complication and re-bleeding were detecting embolization. Conclusion: Vascular injury like PA and AVF are frequent complication after PCNL that needs to be detected and managed. Based on our study, angioembolization is the preferred method for the treatment of vascular and parenchymal injury as it can detect and immediately treated once they are detected and also it has high success rate.

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Cite the article

Salimi J, Siahkalmahalleh MR, Yazdi SAM. Endovascular Management of Post-PCNL Vascular Injuries. Clin Surg. 2022; 7: 3554..