Treatment of delayed bleeding after percutaneous lithotripsy

P. Fortunato, M. Schettini, M. Gallucci

Research output: Contribution to journalArticle

Abstract

This study presents our experience of late hemorrhagic complications and their treatment. From 1984 to 1997 827 percutaneous operations for renocalyceal calculosis (790) and lumbar ureter calculosis (37) were performed. The percutaneous access included the following steps: a retrograde ureteral catheterism, a puncture of the kidney in the posterolateral region, dilation with coaxial Alken dilatators up to 24 Fr, introduction of the nephroscope. Calculi were originally removed with an ultrasound lithotriptor and later with ballistic energy. At the end of the procedure we inserted a 24 Fr. Couvelaire nephrostomic catheter, removed after 72 h. Late bleeding occurred in 3 patients (0.4%) after a mean period of 14 days (range 10-20). With an angiographic catheter, a lesion of the inferior polar artery was observed in one case, and of an interlobar artery in the other two cases. Embolization of the injured vessel with tungsten coils resolved the bleeding quickly in all cases, with a 100% success rate. The incidence of serious vascular lesions due to percutaneous renal lithotripsy is low. Generally the extraparenchymal arterial vessels are affected. Bleeding in these cases cannot be resolved with the nephrostomic catheter because of lack of strong tissue for extravasal support. Treatment of choice for vascular lesions is embolization with a radiological technique which not only resolves bleeding but is also a kidney-sparing technique.

Original languageEnglish
Pages (from-to)291-295
Number of pages5
JournalActa Urologica Italica
Volume12
Issue number6
Publication statusPublished - 1998

Fingerprint

Lithotripsy
Hemorrhage
Lithiasis
Catheters
Kidney
Blood Vessels
Arteries
Tungsten
Calculi
Therapeutics
Ureter
Punctures
Dilatation
Incidence

Keywords

  • Hemorrhage
  • Kidney stones
  • Percutaneous procedures

ASJC Scopus subject areas

  • Urology

Cite this

Fortunato, P., Schettini, M., & Gallucci, M. (1998). Treatment of delayed bleeding after percutaneous lithotripsy. Acta Urologica Italica, 12(6), 291-295.

Treatment of delayed bleeding after percutaneous lithotripsy. / Fortunato, P.; Schettini, M.; Gallucci, M.

In: Acta Urologica Italica, Vol. 12, No. 6, 1998, p. 291-295.

Research output: Contribution to journalArticle

Fortunato, P, Schettini, M & Gallucci, M 1998, 'Treatment of delayed bleeding after percutaneous lithotripsy', Acta Urologica Italica, vol. 12, no. 6, pp. 291-295.
Fortunato P, Schettini M, Gallucci M. Treatment of delayed bleeding after percutaneous lithotripsy. Acta Urologica Italica. 1998;12(6):291-295.
Fortunato, P. ; Schettini, M. ; Gallucci, M. / Treatment of delayed bleeding after percutaneous lithotripsy. In: Acta Urologica Italica. 1998 ; Vol. 12, No. 6. pp. 291-295.
@article{dc739cc2e54d40faa733fc25b0f57800,
title = "Treatment of delayed bleeding after percutaneous lithotripsy",
abstract = "This study presents our experience of late hemorrhagic complications and their treatment. From 1984 to 1997 827 percutaneous operations for renocalyceal calculosis (790) and lumbar ureter calculosis (37) were performed. The percutaneous access included the following steps: a retrograde ureteral catheterism, a puncture of the kidney in the posterolateral region, dilation with coaxial Alken dilatators up to 24 Fr, introduction of the nephroscope. Calculi were originally removed with an ultrasound lithotriptor and later with ballistic energy. At the end of the procedure we inserted a 24 Fr. Couvelaire nephrostomic catheter, removed after 72 h. Late bleeding occurred in 3 patients (0.4{\%}) after a mean period of 14 days (range 10-20). With an angiographic catheter, a lesion of the inferior polar artery was observed in one case, and of an interlobar artery in the other two cases. Embolization of the injured vessel with tungsten coils resolved the bleeding quickly in all cases, with a 100{\%} success rate. The incidence of serious vascular lesions due to percutaneous renal lithotripsy is low. Generally the extraparenchymal arterial vessels are affected. Bleeding in these cases cannot be resolved with the nephrostomic catheter because of lack of strong tissue for extravasal support. Treatment of choice for vascular lesions is embolization with a radiological technique which not only resolves bleeding but is also a kidney-sparing technique.",
keywords = "Hemorrhage, Kidney stones, Percutaneous procedures",
author = "P. Fortunato and M. Schettini and M. Gallucci",
year = "1998",
language = "English",
volume = "12",
pages = "291--295",
journal = "Acta Urologica Italica",
issn = "0394-2511",
publisher = "S. Karger AG",
number = "6",

}

TY - JOUR

T1 - Treatment of delayed bleeding after percutaneous lithotripsy

AU - Fortunato, P.

AU - Schettini, M.

AU - Gallucci, M.

PY - 1998

Y1 - 1998

N2 - This study presents our experience of late hemorrhagic complications and their treatment. From 1984 to 1997 827 percutaneous operations for renocalyceal calculosis (790) and lumbar ureter calculosis (37) were performed. The percutaneous access included the following steps: a retrograde ureteral catheterism, a puncture of the kidney in the posterolateral region, dilation with coaxial Alken dilatators up to 24 Fr, introduction of the nephroscope. Calculi were originally removed with an ultrasound lithotriptor and later with ballistic energy. At the end of the procedure we inserted a 24 Fr. Couvelaire nephrostomic catheter, removed after 72 h. Late bleeding occurred in 3 patients (0.4%) after a mean period of 14 days (range 10-20). With an angiographic catheter, a lesion of the inferior polar artery was observed in one case, and of an interlobar artery in the other two cases. Embolization of the injured vessel with tungsten coils resolved the bleeding quickly in all cases, with a 100% success rate. The incidence of serious vascular lesions due to percutaneous renal lithotripsy is low. Generally the extraparenchymal arterial vessels are affected. Bleeding in these cases cannot be resolved with the nephrostomic catheter because of lack of strong tissue for extravasal support. Treatment of choice for vascular lesions is embolization with a radiological technique which not only resolves bleeding but is also a kidney-sparing technique.

AB - This study presents our experience of late hemorrhagic complications and their treatment. From 1984 to 1997 827 percutaneous operations for renocalyceal calculosis (790) and lumbar ureter calculosis (37) were performed. The percutaneous access included the following steps: a retrograde ureteral catheterism, a puncture of the kidney in the posterolateral region, dilation with coaxial Alken dilatators up to 24 Fr, introduction of the nephroscope. Calculi were originally removed with an ultrasound lithotriptor and later with ballistic energy. At the end of the procedure we inserted a 24 Fr. Couvelaire nephrostomic catheter, removed after 72 h. Late bleeding occurred in 3 patients (0.4%) after a mean period of 14 days (range 10-20). With an angiographic catheter, a lesion of the inferior polar artery was observed in one case, and of an interlobar artery in the other two cases. Embolization of the injured vessel with tungsten coils resolved the bleeding quickly in all cases, with a 100% success rate. The incidence of serious vascular lesions due to percutaneous renal lithotripsy is low. Generally the extraparenchymal arterial vessels are affected. Bleeding in these cases cannot be resolved with the nephrostomic catheter because of lack of strong tissue for extravasal support. Treatment of choice for vascular lesions is embolization with a radiological technique which not only resolves bleeding but is also a kidney-sparing technique.

KW - Hemorrhage

KW - Kidney stones

KW - Percutaneous procedures

UR - http://www.scopus.com/inward/record.url?scp=0032461228&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032461228&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0032461228

VL - 12

SP - 291

EP - 295

JO - Acta Urologica Italica

JF - Acta Urologica Italica

SN - 0394-2511

IS - 6

ER -