Endovascular management of post PCNL vascular injuries

Abstract

Key Clinical MessageAlthough percutaneous nephrolithotomy (PCNL) is a gold standard treatment of large kidney stones, vascular injuries like pseudoaneurysm (PA) and arteriovenous fistula (AVF) may occur due to renal punctures. These endovascular complications need urgent intervention to be diagnosed and managed early. In this case series, 14 patients who had hematuria after PCNL were managed by using angiography to identify the vascular pathology. Among them, we identified 10 patients with PA and 4 patients with AVF, 1 patient with both subscapular hematoma and PA. Angiographic embolization was done successfully in all patients. Based on our results, in cases with peripheral parenchymal damage, PA was common and in cases with hilar damage, AVF was common. No other complication and rebleeding was detected after embolization. Based on our study, angiography can be used as a safe and effective method to detect and treat vascular injuries immediately and successfully.