Category: Clinical Stones: PCNL
Introduction & Objective :
The aim of this study is to present angiographic findings and interventional management of severe bleeding complications of percutaneous nephrolitotomy (PNL).
We retrospectively reviewed the data of patients who undergone PNL procedure at our institution between January 2008 and February 2018. After PNL operation patients with countinuing hematuria or gross hematuria, hypotension and decrasing hematocrit that did not respond to conservative treatment underwent renal angiography and subseqent selective embolization.
Of the 1387 patients, 10 (0,7%)required angiography and embolization for bleeding control. The mean time to the onset of severe bleeding was 8,1 (2-17)days. Renal angiographies revealed pseudoaneurysm in 6, arteriovenous fistula (AVF) in 1, a combination of active contrast extravasation and AVF in 1, two separete segmental artery lesions (a pseudoaneurysm with active contrast extravasation into calyceal system and an AVF and a large pseudoaneurysm with AVF ) in 2 patients. Superselective catheterisation of the injured vessels was performed with a coaxial microcatheter and 0,018 inch fibered platinum microcoils (mean number 4,8 and range 1 to 9) were used to occlude the lesions. Succesful embolization was achieved without any complications in all patients and none required postprocedural any further treatment or blood transfusion.
Massive hematuria is rare complication of PNL and it can be succesfully managed with embolization.
Yusuf Ã–zlÃ¼lerden– Merkez, Denizli, Turkey
Sinan Ã‡elen– assistsnt of professor, pamukkale university, Merkez, Denizli, Turkey
Ahmet Baki YaÄŸcÄ±– Merkez, Denizli, Turkey
Muhammet Arslan– Merkez, Denizli, Turkey
Ã–mer Levent Tuncay– professor, pamukkale university, Merkez, Denizli, Turkey