Endourologic Treatment of Late Migration of Embolization Causing Nephrolithiasis in Two Patients

Thulium laser extraction of angioembolization coils in patient presenting with nephrolithiasis: A case report

Renal Artery Embolization (RAE) is a first-line treatment for arteriovenous fistula complications, which may occur following percutaneous nephrolithotomy (PCNL). A rare complication of RAE is metal coil migration, which may present with nephrolithiasis symptoms, including hematuria and flank pain. Imaging like Computed Tomography (CT) Angiography can help assess the risk of hemorrhage due to coil location relative to vasculature. Subsequently, ureteroscopy can be done with thulium laser excision of the coils and lithotripsy of adherent stone. This case is one of the first to demonstrate that endourological thulium laser excision is a safe and effective management for migrated angioembolization coils.

Erosion of embolization coil into the renal collecting system: Retrograde fragmentation of stone and coil via thulium laser lithotripsy

A 50-year-old female developed kidney stones on an eroded embolization coil 16 months after percutaneous nephrolithotomy (PCNL) related bleeding complications. Retrograde ureteroscopy and thulium laser lithotripsy was performed to fragment the exposed portion of the coil into clinically insignificant pieces. Thulium laser coil fragmentation remains a potential strategy to remove eroded coils and their associated kidney stones; however, recurrent stone formation on the coil stump may necessitate repeat intervention if this conservative approach is pursued over radical antegrade coil removal. This case highlights the importance of continued surveillance and multidisciplinary management in preventing and treating coil erosion after PCNL.