Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(03): 293-297
DOI: 10.4103/ijri.IJRI_54_17
Genitourinary Radiology

Endovascular management of iatrogenic renal vascular injuries complicating percutaneous nephrolithotomy: Role of renal angiography and embolization; an analysis of 159 cases

J Venkateswarlu
Department of Radiology, Deccan College of Medical Sciences, Hyderabad, Telangana, India
,
Sravan Kumar M
Department of Radiology, Deccan College of Medical Sciences, Hyderabad, Telangana, India
,
Ravindra P Babu
Department of Radiology, Deccan College of Medical Sciences, Hyderabad, Telangana, India
,
Anand Abkari
Department of Radiology, Deccan College of Medical Sciences, Hyderabad, Telangana, India
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Objective: To describe the use of renal angiography in the detection of renal vascular injuries following percutaneous nephrolithotomy and to assess the efficacy of endovascular management of these complications. Materials and Methods: This was a retrospective review of 159 consecutive patients over a period of 12 years from 2005 to 2016 who presented with significant post nephrolithotomy hemorrhage and who were evaluated by renal angiography as a first-line diagnostic study, followed by embolization of identified renal vascular injuries in the same session. The parameters assessed for each patient included type of renal vascular injury identified, type of embolic material and therapeutic outcome. Results: Renal vascular lesions identified in 119 patients were treated with embolization with complete resolution of hemorrhage, no further clinical deterioration and preservation of renal function. Conclusions: Renal vascular injury is a rare complication of percutaneous nephrolithotomy. Early renal angiography and selective embolization can play an integral diagnostic and therapeutic role.

Keywords

Angiography - embolization, nephrolithotomy - percutaneous - therapeutic


Publication History

Article published online:
27 July 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Al-Kohlany KM, Shokeir AA, Mosbah A. Treatment of complete staghorn stones: A prospective randomized comparison of open surgery versus percutaneous nephrolithotomy. J Urol 2005;173:469-73.
  • 2 Kim SC, Kuo RL, Lingeman JE. Percutaneous nephrolithotomy: An update. Curr Opin Urol 2003;13:235-41.
  • 3 Phadke RV, Sawlani V, Rastogi H. Iatrogenic renal vascular injuries and their radiological management. Clin Radiol 1997;52:119-23.
  • 4 Martin X, Murat FJ, Feitosa LC, Rouvière O, Lyonnet D, Gelet A, et al. Severe bleeding after nephrolithotomy; Results of therapeutic embolization. Eur Urol 2000;37:136-9.
  • 5 Vignali C, Lonzi S, Bargellini I, Cioni R, Petruzzi P, Caramella D, et al. Vascular injuries after percutaneous renal procedures: Treatment by transcatheter embolization. Eur Radiol 2004;14:723-9.
  • 6 Wang C, Mao Q, Tan F, Shen B. Superselective renal artery embolization in the treatment of renal hemorrhage. Ir J Med Sci 2013;183:5963.
  • 7 Uflacker R, Paolini RM, Lima S. Management of traumatic hematuria by selective renal artery embolization. J Urol 1984;132:662-6.
  • 8 Cantasdemir M, Adaletli I, Cebi D, Kantarci F, Selcuk ND, Numan F. Emergency endovascular embolization of traumatic intrarenal arterial pseudoaneurysms with N-butyl cyanoacrylate. Clin Radiol 2003;58:560.
  • 9 Chiramel GK, Keshava SN, Moses V, Kekre N, Tamilarasi V, Devasia A. Clinical outcomes of endovascularly managed iatrogenic renal hemorrhages. Indian J Radiol Imaging 2015;25:380-90.
  • 10 Martin X, Murat FJ, Feltosa LC. Severe bleeding after nephrolithotomy: Results of hyperselective embolization. Eur Urol 2000;37:136-9.