Computed tomography angiography and three-dimensional reconstruction of renal arteries in diagnosing the bleedings after mini-percutaneous nephrolithotomy: a single-center experience of 7 years.
Urology 2022;
169:47-51. [PMID:
35908741 DOI:
10.1016/j.urology.2022.07.028]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/29/2022] [Accepted: 07/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE
This study aimed to investigate the role of computed tomography angiography (CTA) and three-dimensional reconstruction of renal arteries in the evaluation of bleeding after mini- percutaneous nephrolithotomy (PCNL).
METHODS
31 consecutive patients with continuous renal hemorrhage after mini-PCNL were enrolled from January 2015 to January 2022. Demographic and clinical data were retrospectively recorded and analyzed. All patients had received CTA evaluation and subsequently digital subtraction angiography (DSA) embolization to manage renal bleeding. CTA and 3D reconstruction of renal arteries were performed using the 320 multi-detector computed tomography technique and the images were evaluated by experienced radiologists. DSA embolization were performed by an interventional radiologist with more than 10 years of experiences.
RESULTS
CTA and 3D construction of renal arteries showed 28 cases of vascular lesions (28/31, 90.3%), including 15 cases of pseudoaneurysm (15/28, 53.6%), 9 cases of arteriovenous fistula (9/28, 32.1%), and 4 cases of suspicious bleeding spot (4/28, 14.3%). While DSA revealed 31 cases of vascular lesions (100%), including 15 cases of pseudoaneurysm (15/31, 48.4%), 10 cases of arteriovenous fistula (10/31, 32.3%), 6 cases of bleeding spot and (6/31, 19.4%). The serum creatinine level was elevated slightly before mini-PCNL and after DSA embolization (73.1±18.1 vs 92.1±33.6, p<0.01). 15 patients (15/31, 48.4%) required blood transfusion, with mean blood transfusion volume of 700±660 ml (range, 400-1800ml). The bleeding was controlled without any further severe complications.
CONCLUSIONS
CTA and 3D reconstruction of renal arteries were safe and effective in diagnosing renal arterial bleedings after mini-PCNL, with a sensitivity of 90.3% and a specificity of 100%.
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