RESUMEN
2502 patients with renal stones were treated by PCNL at our center over a period of 13 years starting from 1984. Eighty-four patients were readmitted with delayed bleeding [3.4%]. All but 19 patients [0.8%] were treated conservatively. These 19 patients proved to have significant vascular injuries as documented by selective arteriography in the form of pseudoaneurysms and/or arteriovenous fistulae [18 patients] or vascular lacerations [1 patient]. Embolization with platinum microcoils and/or absolute alcohol controlled bleeding in all but one patient. He was explored, and nephrectomy was decided to save him. Follow-up data of up to 78 months [46.2+20.5] revealed that embolization was a safe procedure with minimal late sequelae. Renal function remained stable. Two patients, however, developed hypertension. The study revealed that the incidence of delayed bleeding after PCNL due to a significant vascular lesion was low [0.8%]. Arteriographic embolization is not only a life-saving procedure but also a kidney-sparing technique
Asunto(s)
Humanos , Masculino , Femenino , Hemorragia/terapia , Vasos Sanguíneos/lesiones , Embolización Terapéutica , Estudios de Seguimiento , Resultado del TratamientoRESUMEN
2502 patients with renal stones were treated by PCNL at our center, over period of 13 years starting from 1984, 84 patients were readmitted with delayed bleeding [3.4%]. All patients were treated conservatively except 19 patients [0.8%]. Those proved to have significant vascular injuries as documented by selective arteriography in the form of pseudoaneurysms and/or arteriovenous fistulas [18 patients] or vascular lacerations [one patient]. Embolization with platinum microcoils and/or absolute alcohol controlled bleeding except in one patient. He was explored and nephrectomy was decided to save him. Follow up data up to 78 months [46.2 + 20.5] revealed that emboilization is a safe procedure with minimal late sequaele. Renal function remained stable. Two patients, however, developed hypertension. The study revealed that, delayed bleeding after PCNL due to significant vascular lesion is low [0.8%]. Arteriographic ambolization is not only a life saving procedure but also a kidney-sparing technique