Endovascular management of vascular complications after percutaneous nephrolithotomy

VASA ◽  
2014 ◽  
Vol 43 (6) ◽  
pp. 459-464 ◽  
Author(s):  
Selim Kervancioglu ◽  
Feyza Gelebek Yilmaz ◽  
Sakip Erturhan
Keyword(s):  
Treatment Outcomes ◽  
Percutaneous Nephrolithotomy ◽  
Coil Embolization ◽  
Vascular Complications ◽  
Arterial Embolization ◽  
Arterial System ◽  
Vascular Lesions ◽  
Endovascular Management ◽  
Arterial Complications ◽  
Endovascular Coil Embolization

Background: Bleeding is one of the most common and most important complications of percutaneous nephrolithotomy (PCNL), which is mainly controlled with conservative treatment options. Transcatheter arterial embolization is required in less than 1 % of the patients undergoing PCNL. There are only a few studies about endovascular treatment of vascular complications of PCNL. The purpose of this study was to evaluate renal arterial complications of PCNL and treatment outcomes with endovascular coil embolization. Patients and methods: This retrospective study evaluated 16 patients who underwent endovascular management for complications after PCNL, including diagnostic angiography. We analyzed the angiographic appearances of the vascular lesions that caused hemorrhages, treatment outcomes for endovascular coil embolization, and renal parenchymal loss rate following this treatment. Results: Seven patients had a pseudoaneurysm, two patients had an arteriocaliceal fistula (ACF), five patients had a pseudoaneurysm and an arteriovenous fistula (AVF), and two patients had a pseudoaneurysm and an ACF. Of the 14 patients with pseudoaneurysms, five had more than one pseudoaneurysm. Endovascular coil embolization was successful in all patients, and it was able to stop the bleeding. After embolization, 12 patients had less than 10 % parenchymal loss, and 4 patients had 10–20 % parenchymal loss. Mean hospital stay after embolization was 2.3 ± 0.7 days (range, 1 to 3 days). Conclusions: The injuries seen in the intrarenal arterial system during the PCNL procedure can result in pseudoaneurysms and/or AVFs and/or ACFs, and more than one artery can be harmed. Arterial complications of PCNL can be treated with endovascular coil embolization while preserving renal function at a maximum level.

scholarly journals Endovascular management of a vein of Galen aneurysmal malformation in an infant with challenging femoral arterial access

2016 ◽  
Vol 18 (2) ◽  
pp. 231-234 ◽  
Author(s):  
Bharathi D. Jagadeesan ◽  
Haralabos Zacharatos ◽  
David R. Nascene ◽  
Andrew W. Grande ◽  
Daniel J. Guillaume ◽  
...  
Keyword(s):  
Patent Foramen Ovale ◽  
Transarterial Embolization ◽  
Arterial Embolization ◽  
Venous Access ◽  
Arterial System ◽  
Vein Of Galen ◽  
Foramen Ovale ◽  
Endovascular Management ◽  
Arterial Access ◽  
Femoral Arterial Access

A 5-month-old infant was to be treated with elective transarterial embolization for a vein of Galen aneurysmal malformation (VGAM). A team of endovascular surgical neuroradiologists, pediatric interventional radiologists, and pediatric cardiologists attempted conventional femoral arterial access, which was unsuccessful given the small caliber of the femoral arteries and superimposed severe vasospasm. Thereafter, eventual arterial access was achieved by navigating from the venous to the arterial system across the patent foramen ovale following a right femoral venous access. Embolization was then successfully performed. At a later date, the child underwent successful transvenous balloon-assisted embolization and eventual arterial embolization with cure of the VGAM.

scholarly journals Hemorrhagic complications after percutaneous nephrolithotomy: angiographic diagnosis and management by transcatheter arterial embolization

2020 ◽  
Vol 53 (6) ◽  
pp. 390-396
Author(s):  
Vinicius Adami Vayego Fornazari ◽  
Rômulo Florêncio Tristão Santos ◽  
Thiago Franchi Nunes ◽  
Rodrigo Perrella ◽  
Tiago Magalhães Freire ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Transcatheter Arterial Embolization ◽  
Arterial Embolization ◽  
Vascular Lesions ◽  
Common Symptom ◽  
Macroscopic Hematuria ◽  
Hemorrhagic Complications ◽  
Ethiodized Oil ◽  
Angiographic Diagnosis

Abstract Objective: To identify the main hemorrhagic complications after percutaneous nephrolithotomy, as well as the results obtained with transcatheter arterial embolization (TAE) at an interventional radiology center. Materials and Methods: This was a retrospective analysis of patients undergoing TAE for the treatment of hemorrhagic complications after percutaneous nephrolithotomy. All patients underwent computed tomography angiography (CTA). Results: We evaluated a total of nine patients. At emergency department readmission, the most common symptom was macroscopic hematuria, which was seen in five patients. Three patients had an isolated pseudoaneurysm, two had a pseudoaneurysm together with active bleeding (perirenal hematoma), and one had a pseudoaneurysm together with arteriocalyceal fistula. Arteriovenous fistula was diagnosed in three patients and was not seen in combination with other vascular lesions. We did not identify arteriocalyceal fistula in isolation. Five patients underwent TAE with 6 × 15 mm and 6 × 20 mm microcoils. Four patients underwent TAE with n-butyl-2-cyanoacrylate and ethiodized oil. Follow-up CTAs revealed no complications. Conclusion: Because of its high diagnostic accuracy, CTA provides the interventional radiologist with valuable data for individualized therapeutic planning. The TAE procedure is safe and effective. It can therefore be used as a first-line treatment for hemorrhagic complications resulting from percutaneous renal procedures.

Endovascular management of vascular lesions after percutaneous nephrolithotomy

2015 ◽  
Vol 14 (6) ◽  
pp. e1300
Author(s):  
F-G. Burtea ◽  
B. Braticevici ◽  
B. Dorobat ◽  
Y. Salaheddin ◽  
F. Tanase ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Vascular Lesions ◽  
Endovascular Management

scholarly journals Packing Technique with or without Remodeling for Endovascular Coil Embolization of Renal Artery Aneurysms: Safety, Efficacy and Mid-Term Outcomes

2021 ◽  
Vol 10 (2) ◽  
pp. 326
Author(s):  
Grégory Secco ◽  
Olivier Chevallier ◽  
Nicolas Falvo ◽  
Kévin Guillen ◽  
Pierre-Olivier Comby ◽  
...  
Keyword(s):  
Renal Artery ◽  
Success Rate ◽  
Coil Embolization ◽  
Preventive Treatment ◽  
Parent Artery ◽  
Technical Success ◽  
Technical Success Rate ◽  
Endovascular Coil Embolization ◽  
Lower Morbidity

The endovascular treatment of renal artery aneurysms (RAAs) has lower morbidity and shorter stay lengths compared to surgical repair. Here, we describe coil packing with or without remodeling and assess outcomes and complications. We retrospectively identified the 19 consecutive preventive endovascular RAA coil embolizations done in 18 patients at our center in 2010–2020. Patient and aneurysm characteristics, technical success rate, complications, and recurrences were recorded. Mean patient age was 63 ± 13 years. The RAA was >1.5 cm in 11 cases, and in four cases, the aneurysm-to-parent artery size ratio was >2. Simple coiling was performed for 11 (57.9%) aneurysms, stent-assisted coiling for seven (36.8%) aneurysms, and balloon-assisted coiling for one (5.3%) aneurysm. Technical success rate was 100%. Complete definitive RAA exclusion was achieved with a single procedure for 17 (89.5%) aneurysms, whereas two (10.5%) aneurysms required a repeat procedure. Four minor complications occurred but resolved with no long-term consequences. No major complications occurred during the mean follow-up of 41.1 ± 29.7 months. Coil embolization by sac packing or remodeling proved very safe and effective. Together with the known lower morbidity and shorter stay length compared to open surgery, these data indicate that this endovascular procedure should become the preventive treatment of choice for RAAs.

scholarly journals Intraprocedural Angiographic CT as a Valuable Tool in the Course of Endovascular Treatment of Direct Sinus Cavernous Fistulas

2012 ◽  
Vol 18 (3) ◽  
pp. 326-332 ◽  
Author(s):  
P. Gölitz ◽  
T. Struffert ◽  
M. Arc Saake ◽  
F. Knossalla ◽  
A. Doerfler
Keyword(s):  
Endovascular Treatment ◽  
Coil Embolization ◽  
Parent Artery ◽  
Angiographic Ct ◽  
Complex Anatomy ◽  
Procedural Complications ◽  
Endovascular Coil Embolization ◽  
Contrast Medium Injection ◽  
Carotid Cavernous Fistulas ◽  
Coil Migration

This investigation aimed to demonstrate the potential of intraprocedural angiographic CT in monitoring complex endovascular coil embolization of direct carotid cavernous fistulas. Angiographic CT was performed as a dual rotational 5 s run with intraarterial contrast medium injection in two patients during endovascular coil embolization of direct carotid cavernous fistulas. Intraprocedural angiographic CT was considered helpful if conventional 2D series were not conclusive concerning coil position or if a precise delineation of the parent artery was impossible due to a complex anatomy or overlying coil material. During postprocessing multiplanar reformatted and dual volume images of angiographic CT were reconstructed. Angiographic CT turned out to be superior in the intraprocedural visualization of accidental coil migration into the parent artery where conventional 2D-DSA series failed to reliably detect coil protrusion. The delineation of coil protrusion by angiographic CT allowed immediate correct coil repositioning to prevent parent artery compromising. Angiographic CT can function as a valuable intraprocedurally feasible tool during complex coil embolizations of direct carotid cavernous fistulas. It allows the precise visualization of the cerebral vasculature and any accidental coil protrusion can be determined accurately in cases where conventional 2D-DSA series are unclear or compromised. Thus angiographic CT might contribute substantially to reduce procedural complications and to increase safety in the management of endovascular treatment of direct carotid cavernous fistulas.

Feasibility and Limitations of Endovascular Coil Embolization of Anterior Communicating Artery Aneurysms: Morphological Considerations

Neurosurgery ◽  
2006 ◽  
Vol 59 (1) ◽  
pp. 43-52 ◽  
Author(s):  
John K. Birknes ◽  
Sung-Kyun Hwang ◽  
Aditya S. Pandey ◽  
Kevin Cockroft ◽  
Anne-Marie Dyer ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysms ◽  
Endovascular Coil Embolization

scholarly journals Endovascular Coil Embolization of a Posterior Communicating Artery Aneurysm: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (6) ◽  
pp. E597-E598
Author(s):  
Maureen A Darwal ◽  
Zakaria Hakma ◽  
Mandy J Binning ◽  
Adam Arthur ◽  
Bain Mark ◽  
...  
Keyword(s):  
New York ◽  
Endovascular Treatment ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Posterior Communicating Artery ◽  
International Subarachnoid Aneurysm Trial ◽  
Endovascular Coil Embolization ◽  
Posterior Communicating Artery Aneurysm ◽  
Set Up

Abstract Since the International Subarachnoid Aneurysm Trial,1 endovascular treatment has been the favored treatment for appropriate ruptured intracranial aneurysms. While our endovascular technology has advanced to allow us to treat the majority of intracranial aneurysms, simple coil embolization is still the most common modality. This video demonstrates the fundamentals of aneurysm catheterization and coiling for safe treatment. In addition, the set-up and devices are detailed. This video is to add to the library of basic techniques that will aid a large number of practitioners. This patient consented to endovascular treatment. The video demonstrates endovascular coil embolization of a posterior communicating artery aneurysm in a 76-yr-old female who presented with a subarachnoid hemorrhage. Image of biplane suite in video used courtesy of Siemens Medical Solutions USA, Inc. Illustration at 5:12 reprinted from Yasargil MG, et al, Microneurosurgery IV B, p. 9, Thieme, New York, 1995.

scholarly journals Early experience with a novel net temporary bridging device (Cascade) to assist endovascular coil embolization of intracranial aneurysms

2020 ◽  
pp. 1-9
Author(s):  
Alejandro Tomasello ◽  
David Hernandez ◽  
Laura Ludovica Gramegna ◽  
Sonia Aixut ◽  
Roger Barranco Pons ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Type I ◽  
Type Ii ◽  
Unruptured Aneurysms ◽  
Complete Obliteration ◽  
Acute Subarachnoid Hemorrhage ◽  
Endovascular Coil Embolization ◽  
The Mean

OBJECTIVEThe goal of this study was to evaluate the effectiveness and safety of a new noncompletely occlusive net-assisted remodeling technique in which the Cascade net device is used for temporary bridging of intracranial aneurysms.METHODSBetween July 2018 and May 2019, patients underwent coil embolization with the Cascade net device within 4 centers in Europe. Analysis of angiographic (modified Raymond-Roy classification [MRRC]) and clinical outcomes data was conducted immediately following treatment and at the 6-month follow-up.RESULTSFifteen patients were included in the study (mean age 58 ± 13 years, 11/15 [73.3%] female). Ten patients had unruptured aneurysms, and 5 presented with ruptured aneurysms with acute subarachnoid hemorrhage. The mean aneurysm dome length was 6.27 ± 2.33 mm and the mean neck width was 3.64 ± 1.19 mm. Immediately postprocedure, MRRC type I (complete obliteration) was achieved in 11 patients (73.3%), whereas a type II (residual neck) was achieved in 4 patients (26.7%). Follow-up examination was performed in 7/15 patients and showed stabilization of aneurysm closure with no thromboembolic complications and only 1 patient with an increased MRRC score (from I to II) due to coil compression.CONCLUSIONSInitial experience shows that the use of a new noncompletely occlusive net-assisted remodeling technique with the Cascade net device may be safe and effective for endovascular coil embolization of intracranial aneurysms.

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