The Efficacy and Safety of Transcatheter Arterial Embolization to Treat Renal Hemorrhage After Percutaneous Nephrolithotomy

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2019 May 31

PMID 31143774

Citations 17

Authors

Nan Du

Jing-Qin Ma

Jian-Jun Luo

Qing-Xin Liu

Zi-Han Zhang

Min-Jie Yang

Tian-Zhu Yu

Yun Tao

Rong Liu

Wen Zhang

Zhi-Ping Yan

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this study was to evaluate the safety and efficacy of transcatheter arterial embolization (TAE) in patients with renal hemorrhage after percutaneous nephrolithotomy (PCNL) and evaluate the risk factors that may result in severe bleeding requiring TAE.

Methods: We retrospectively reviewed 121 patients with post-PCNL renal hemorrhage. Thirty-two patients receiving endovascular embolization were compared with 89 patients only receiving conservative treatment. The demographic and clinical data were recorded and compared between the two groups. The values of estimated glomerular filtration rate (eGFR) and serum creatinine (SCr) were recorded preoperatively, postoperatively, and at last follow-up and analyzed to evaluate the safety and efficiency of TAE.

Results: The successful hemostasis rate of conservative therapy was 73.6% (89/121) and that of TAE was 100% (32/32). SCr and eGFR were not significantly different before PCNL and after the last follow-up of TAE (SCr: 0.95 vs. 0.95 mg/dl, =0.857; eGFR: 86.77 vs. 86.18 ml/min/1.73m, =0.715). The univariate analysis demonstrated that advanced age, urinary tract infection, and diabetes mellitus were significantly associated with severe bleeding during PCNL. Multivariate analysis further identified that diabetes mellitus was an independent risk factor for severe bleeding needing TAE [odds ratio (OR): 3.778, 95% confidence interval (CI):1.276-11.190, and =0.016].

Conclusion: TAE is a safe and effective procedure to treat renal hemorrhage that cannot be resisted by conservative treatment after PCNL. Diabetes mellitus was associated with high risks of severe bleeding needing TAE after PCNL.

Citing Articles

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Post-percutaneous nephrolithotomy pseudo aneurysm formation treated by coil embolization; A study of seven cases.

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Acute liver injury and contralateral pleural effusion as two rare complications following percutaneous nephrolithotomy: a case report.

Kazemi R, Jandaghi F, Montazeri F, Salehi H Am J Clin Exp Urol. 2024; 12(1):46-51.

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Influencing Factors of Massive Hemorrhage and High-Grade Renal Vascular Injury after PCNL: A Retrospective Comparative Study.

He Q, Song Z, Wang X, Hou B, Hao Z Int J Clin Pract. 2023; 2023:5521691.

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Risk Factors for Intra-operative Bleeding in Percutaneous Nephrolithotomy in an Academic Center: A Retrospective Study.

Nasseh H, Mokhtari G, Ghasemi S, Biazar G, Leyli E, Gholamjani Moghaddam K Anesth Pain Med. 2023; 12(4):e126974.

PMID: 36937085 PMC: 10016121. DOI: 10.5812/aapm-126974.

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