Super selective embolization of the renal arteries with iatrogenic bleeding after percutaneous nephrolithotomy

The aim of this work is to study the results of superselective embolization of bleeding renal vessels after percutaneous aids for urolithiasis. 1723 percutaneous nephrolithomies performed in the urology clinic of the First Moscow State Medical University named after I,M,Sechenov until 2015 were analyzed. Hemorrhagic complications were detected in 83 (4.8%) patients, transfusion was required in 37 (2.1%) observations, SSE in 28 (1.6%). 2 (0.1%) patients underwent nephrectomy at the stage of development and introduction of PNL and lack of the possibility of performing SSE. In all the observations, it was possible to achieve a good clinical effect without resorting to open surgery. Complications during embolization and postembolization period were not observed. SSE is an effective minimally invasive method for endovascular diagnosis and treatment of bleeding caused by iatrogenic AVF kidney. This method avoids the organ-carrying benefit and eliminates a formidable complication.

перкутанная нефролитотомия, кровотечение при перкутанных операциях, артериовенозные фистулы, ангиография, суперселективная эмболизация, percutaneous nephrolithotomy, bleeding during percutaneous operations, arteriovenous fistulas, angiography, superselective embolization

1. Аляев Ю.Г., Григорьев Н.А., Акопян Г.Н., Безруков Е.А., Али С.Х., Али Х.М. Малоинвазивная перкутанная нефро-литотрипсия без нефростомы. Урология. 2014. № 4. С. 76-79

2. Desai J., Zeng G., Zhao Z., Zhong W., Chen W., Wu W. A novel technique of ultramini-percutaneous nephrolithotomy: Introduction and an initial experience for treatment of upper urinary calculi less than 2 cm. BiomedRes Int. 2013;2013:790-793

3. Мартов А.Г., Дутов С.В., Андронов А.С. Ультраминиперкутанная нефролитотрипсия в лечении камней почек. Урология 2016, №2, 82-88

4. Skolarikos A, Alivizatos G, de la Rosette JJ. Percutaneous nephrolithotomy and its legacy. Eur Urol. 2005;47(1):22-8.

5. El-Nahas AR, Shokeir AA, El-Assmy AM, Mohsen T, Shoma AM, et al. Post-percutaneous nephrolithotomy extensive haemorrhage: a study of risk factors. J Urol. 2007;177(2):576-9.

6. Seitz C, Desai M, Hacker A, et al. Incidence, prevention, and management of complications following percutaneous nephrolitholapaxy. Eur Urol 2012 Jan;61(1):146-58

7. Сорокин Н.И. Суперселективная окклюзия почечных артерий: дисс.. док. мед. наук. М.; 2015. 346с.

8. Аляев Ю.Г., Акопян Г.Н. Спонтанный разрыв почки. Москва, 2010. 156с.

9. Глыбочко П.В., Аляев Ю.Г., Кондрашин С.А., Григорьев Н.А., Акопян Г.Н., Шпоть Е.В., Аксенов А.В., Марти росян ГА, Сорокин Н.И. Малоинвазивная диагностика и лечение врождённых артериовенозных фистул почки. Клиническая нефрология. 2011. № 6. С. 45-47

10. Глыбочко П.В., Аляев Ю.Г., Кондрашин С.А., Григорьев Н.А., Акопян Г.Н., Шпоть Е.В., Мартиросян Г.А., Сорокин Н.И. Эндоваскулярные методы диагностики и лечения врождённых артериовенозных фистул почки. Медицинский вестник Башкортостана. 2011. Т. 6. № 2. С. 224-227