scholarly journals Risk factors for hemorrhage requiring embolization after percutaneous nephrolithotomy

2015 ◽  
Vol 9 (9-10) ◽  
pp. 594 ◽  
Author(s):  
Sitki Un ◽  
Volkan Cakir ◽  
Cengiz Kara ◽  
Hakan Turk ◽  
Osman Kose ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Radiology Department ◽  
Complication Rates ◽  
Arteriovenous Fistulas ◽  
Predicting Factors ◽  
Mean Size ◽  
The Mean ◽  
Angiography And Embolization ◽  
Interventional Radiology Department ◽  
Renal Abnormalities

Introduction: Percutaneous nephrolithotomy (PCNL) is the primary surgical intervention in kidney stone management. Even though it is performed quite often, the complication rates are also high. Arteriovenous fistulas following extended hemorrhages after PCNL are one of the most serious complications of this operation. Our main objective was to review the data of patients who required angiography and embolization.Methods: In total, we included 1405 patients who underwent PCNL between 2007 and 2014. All patient data were retrospectively reviewed. All patients went under PCNL using fluoroscopy. Following informed consent, all hemorrhagic patients underwent angiography in the interventional radiology department and embolization was performed in patients with a hemorrhage focus point.Results: A total of 147 patients (10.4%) required transfusion for post- PCNL hemorrhages. Of them, 14 (0.99%) underwent angiography and embolization (9 [64.2%] were male and 5 [35.8%] were female, with a mean age of 39.4 ± 10.2). The remaining 133 patients were conservatively managed (81 [60.9%] males and 52 [39.1%] females, with a mean age of 42.3 ± 12.4). When the predicting factors for angiography and embolization were reviewed, renal abnormalities and the mean size of stones were significant in both univariate and multivariate analysis (p < 0.001).Conclusion: Patients with extended and intermittent hematuria should be monitored closely for hemodynamics; if there is an ongoing necessity for transfusion, angiography should be considered.

scholarly journals A Novel Technique of Ultra-Mini-Percutaneous Nephrolithotomy: Introduction and an Initial Experience for Treatment of Upper Urinary Calculi Less Than 2 cm

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Janak Desai ◽  
Guohua Zeng ◽  
Zhijian Zhao ◽  
Wen Zhong ◽  
Wenzhong Chen ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Urinary Calculi ◽  
Renal Stones ◽  
Laser Lithotripsy ◽  
Complication Rates ◽  
Modified Technique ◽  
Average Operative Time ◽  
Grade Ii ◽  
The Mean ◽  
Metal Sheath

Objectives. To describe our novel modified technique of ultra-mini-percutaneous nephrolithotomy (UMP) using of a novel 6 Fr mininephroscope through an 11–13 Fr metal sheath to perform holmium: YAG laser lithotripsy.Methods. The medical records of 36 patients with moderate-sized (<20 mm) kidney stones treated with UMP from April to July 2012 were retrospectively reviewed. Patients were assessed at the 1st day and 1st month postoperatively by KUB and US to assess stone-free status.Results. The mean stone size was 14.9 ± 4.1 mm (rang: 6–20). The average operative time was 59.8 ± 15.9 (30–90) min. The stone-free rate at postoperative 1st day and 1st month was 88.9% and 97.2%. The mean hospital stay was 3.0 ± 0.9 (2–5) days. Complications were noted in 6 (16.7%) cases according to the Clavien classification, including sepsis in 2 (5.6%) cases (grade II), urinary extravasations in 1 (2.8%) case (grade IIIa), and fever in 3 (8.3%) cases (grade II). No patients needed blood transfusion.Conclusions. UMP is technically feasible, safe, and efficacious for moderate-sized renal stones with an advantage of high stone-free rates and low complication rates. However, due to the limits of its current unexplored indications, UMP is therefore a supplement to, not a substitute for, the standard mini-PCNL technology.

scholarly journals Percutaneous Treatment of Thrombosed Hemodialysis Arteriovenous Fistulas: Use of Thromboaspiration and Balloon Angioplasty

2017 ◽  
Vol 90 (1) ◽  
pp. 66-70
Author(s):  
Burak Mehmet Çildağ ◽  
Kutsi Ömer Faruk Köseoğlu
Keyword(s):  
Success Rate ◽  
Balloon Angioplasty ◽  
Mechanical Thrombectomy ◽  
Clinical Success ◽  
Percutaneous Treatment ◽  
Radiology Department ◽  
Secondary Patency ◽  
Complication Rates ◽  
Success Rates ◽  
Arteriovenous Fistulas

Background. Endovascular strategies have been used to manage patients with thrombosed vascular access for hemodialysis. We analyzed primary success rate and patency rates of balloon angioplasty following mechanical thrombectomy for the treatment of thrombosed native arteriovenous fistulas.Methods. This was a retrospective study of 24 patients with thrombosed native arteriovenous fistulas who were referred for treatment in the intervention unit of the Radiology Department. All patients had been performed percutaneous thrombo-aspiration and balloon angioplasty. Technical and clinical success rates as well as the 6th and 12th months primary and secondary patency of fistulas were evaluated .Results. Technical and clinical success was 83%. In the 6 of 20 patients, early re-thrombosis were detected. Patent AVF with primary and secondary patency rates at 6 and 12 months was 55%-40%. The secondary patency rates at 6 and 12 months were 75% and 70%.Conclusion. Mechanical thrombectomy with balloon angioplasty is a minimally invasive and effective procedure for the treatment of thrombosed native arteriovenous fistula. Advantages of this technique are minor complication rates, cost effectiveness, high techni­cal success rate.   

scholarly journals Safety of neuroangiography and embolization in children: complication analysis of 697 consecutive procedures in 394 patients

2015 ◽  
Vol 16 (4) ◽  
pp. 432-438 ◽  
Author(s):  
Ning Lin ◽  
Edward R. Smith ◽  
R. Michael Scott ◽  
Darren B. Orbach
Keyword(s):  
High Volume ◽  
Multivariate Logistic Regression Model ◽  
Morbidity Rate ◽  
Complication Rates ◽  
Arteriovenous Fistulas ◽  
High Volume Center ◽  
Neurological Event ◽  
Neurointerventional Procedures ◽  
Angiography And Embolization

OBJECT The safe treatment of children using catheter-based angiography and embolization poses unique challenges because of the technical factors regarding the size and fragility of access and target vessels, as well as unique pediatric cerebrovascular pathologies. The complication rates for neurointerventional procedures in children have not been established. METHODS The records of a consecutive cohort of pediatric patients who underwent neuroangiography and/or embolization between 2007 and 2013 were reviewed retrospectively to identify both intraprocedural and postprocedural complications. Demographic and clinical risk factors were analyzed with a multivariate logistic regression model. RESULTS The 697 consecutive procedures consisted of 429 diagnostic angiograms and 268 embolizations (mean age of patients 11.1 years; range 4 days to 18 years; 217 females). There were 130 intracranial, 122 extracranial, and 16 spinal embolizations. Pathologies included 28 intracranial arteriovenous malformations (AVMs), 12 spinal AVMs, 19 aneurysms, 29 vein of Galen malformations, 29 dural arteriovenous fistulas, 96 extracranial AVMs, 39 tumors, 3 strokes, and 13 others. Overall, 2 intraprocedural and 1 postprocedural complication (0.7%) occurred in the diagnostic group, all of which were nonneurological events. In the embolization group, 7 intraprocedural and 11 postprocedural complications (6.7%) were observed. Of these complications, 15 were nonneurological events (5.6%), 1 was a short-term neurological event (0.4%), and 2 were long-term neurological events (0.7%). CONCLUSIONS Neither the technical challenges posed by children’s access and target vessels nor the unique neuro-vascular pathologies seen in children need result in an elevated morbidity rate related to neuroangiography and embolization. At a dedicated high-volume center, the complication rates may be lower than those for comparable procedures performed in adults.

scholarly journals Effect of Renal Function on Success and Complications of Percutaneous Nephrolithotomy

2021 ◽  
pp. 68-73
Author(s):  
Serkan Yarimoglu ◽  
Mehmet Erhan Aydin ◽  
Murat Sahan ◽  
Omer Koras ◽  
Onur Erdemoglu ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration ◽  
Percutaneous Nephrolithotomy ◽  
Kidney Stones ◽  
Complication Rates ◽  
Number Of Patients ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objective: In this study, we aimed to compare the success and complication rates of percutaneous nephrolithotomy (PCNL) according to preoperative glomerular filtration rates (GFR) of patients who underwent PCNLdue to kidney stones. Material and Methods: Between January 2012 and December 2016, 794 patients who underwent PCNL due to kidney Stones were evaluated retrospectively. Preoperative GFR values of patients were calculated according to Cockcroft –Gault formula. The patients with preoperative GFR values>90 ml/min, 60-90 ml/min, 30-60 ml/min were respectively defined as group-1, group-2 and group-3. Preoperative and perioperative values, Stone free rates and complication rates were compared between the groups. Postoperatively , <4 mm residual stone was identified as success. Results: There were 466 patients in Group-1, 259 in Group-2 and 67 patients in Group-3. The mean preoperative GFR values of the patients were 118.53 ml/min, 77.76 ml/min and 48.52 ml/min, respectively in group-1, group-2 and group-3 (p <0.001).The mean age of the patients was 62.8±11.47, 51.86±11.10, and60.31±12.7, respectively, in group-1, group-2 and group-3 (p<0.001).The mean Stone burden of the patients were 497.34±518.60 mm2, 517.6±493.8 mm2and 711.06±679.07 mm2, respectively, in group-1, group-2 and group-3 (p=0.013). The number of patients identified with success after surgery was 355 (86.2%), 195 (76.1%) and 50 (74.6%) in group-1, group-2 and group-3, respectively (p = 0.542). The number of patients who develop complications was 114 (%24.65), 57 (%22) and 11 (%16.4) in group-1, group-2 and group-3, respectively (p=0.310). Conclusion: Preoperative GFR valuesare not lonely sufficient to predict success and complications after PCNL. Keywords: Percutaneous nephrolithotomy, renal function, renal stone, glomerular filtration rates

scholarly journals Antegrade insertion of a double J catheter in the treatment of malignant ureteral obstruction: a retrospective analysis of the results obtained with a modified technique at a university hospital

2020 ◽  
Vol 53 (3) ◽  
pp. 155-160
Author(s):  
Rômulo Florêncio Tristão Santos ◽  
Tiago Kojun Tibana ◽  
Edson Marchiori ◽  
Thiago Franchi Nunes
Keyword(s):  
Retrospective Analysis ◽  
Ureteral Obstruction ◽  
Urinary Tract Obstruction ◽  
University Hospital ◽  
Radiology Department ◽  
Technical Failure ◽  
Modified Technique ◽  
Malignant Ureteral Obstruction ◽  
The Mean ◽  
Interventional Radiology Department

Abstract Objective: To analyze the results obtained with a modified antegrade double J catheter insertion (JJ stenting) technique in patients with urinary tract obstruction due to malignancy. Materials and Methods: This was a retrospective analysis of data collected from patients undergoing antegrade JJ stenting for malignant ureteral obstruction in the interventional radiology department of our institution between March 1, 2017 and May 31, 2019. Results: Antegrade JJ stenting was performed in 32 patients (20 women and 12 men). The mean age was 66.2 years among the females and 61.5 years among the males. A total of 53 antegrade JJ stenting procedures were performed. The procedure was successful in 50 cases and failed in 3 (due to migration of the double J catheter in 2 and due to technical failure in 1). Complications occurred in 3 patients (low back pain, in 1, subcapsular hematoma, in 1, and pyelonephritis, in 1). The procedure time ranged from 14 min to 55 min. Conclusion: In patients with ureteral obstruction due to malignancy, antegrade JJ stenting is safe and effective. The technique selected in our study is easily reproduced and can be performed by a trained professional.

scholarly journals Papillary vs non-papillary access during percutaneous nephrolithotomy: Retrospective, match-paired case-control study

2020 ◽  
Vol 92 (1) ◽  
pp. 50-52
Author(s):  
Ahmet Tahra ◽  
Resul Sobay ◽  
Ahmet Bindayi ◽  
Ferhat Yakup Suceken ◽  
Eyup Veli Kucuk
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Transfusion Rate ◽  
Complication Rates ◽  
Residual Stone ◽  
Significant Difference ◽  
Feasible Option ◽  
Stone Material ◽  
The Mean ◽  
Free Status

Objective: The most crucial steps of percutaneous nephrolithotomy (PCNL) are the percutaneous access and dilation of the access route. Recent literature suggests that papillary access to renal calyx is the accepted method. Despite this rule, we do not always make papillary puncture and we puncture wherever we can to achieve stone-free status and reduce unnecessary access. In this study, we present our results with papillary vs non-papillary access in patients with a kidney stone. Material and methods: Two hundred and seven patients with non-papillary access and 69 patients with papillary access who had similar demographics (age, body mass index (BMI), stone size) were selected with pair match analysis (3:1). Preoperative and postoperative data were collected from the patient's chart. Operative time (from starting surgery to nephrostomy tube), drop-in hematocrit level, transfusion rate, duration of hospital stay, perioperative and postoperative complications (Clavien-Dindo Classification) and stone-free status (no or < 3 mm residual stone) were also evaluated in both groups. Results: The mean operative time was similar in between two groups. The mean hematocrit decreases not differ between the two groups (p = 0.56). In papillary group, only 2 patients (3.2%) required transfusion and only one patient (1.4%) in the non-papillary group had a transfusion with no statistically significant difference (p = 0.43). The overall complication rates were 7.1% in the papillary group and 7.2% in the non-papillary group (p = 0.89). Postoperative mean creatinine level was similar between the two groups.  Conclusions: In this study, we found that non-papillary access is a feasible option for PCNL in the terms of stone-free status and complication rates.

scholarly journals All-arthroscopic AMIC® (AT-AMIC) in the treatment of osteochondral talar lesions

2018 ◽  
Vol 12 (2) ◽  
pp. 96-101
Author(s):  
Tiago Soares Baumfeld ◽  
Daniel Soares Baumfeld ◽  
Marcelo Pires Prado ◽  
Caio Augusto de Souza Nery
Keyword(s):  
Case Series ◽  
Treatment Method ◽  
Autologous Bone Graft ◽  
Complication Rates ◽  
Common Site ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Mean Size ◽  
The Mean

Objective: The objective of this study was to report the postoperative clinical outcomes of patients undergoing the all-arthroscopic AMIC® technique (AT-AMIC®) combined with autologous bone graft placement as necessary. Methods: This was a case series of 17 consecutive patients who underwent AT-AMIC® between January 2016 and April 2017. Nine men and eight women between 15 and 67 years of age were diagnosed with an osteochondral talar lesion (OTL) and underwent surgery only after failure ofconservative treatment of at least 3 months. Patients answered the AOFAS scale before surgery and at the final follow-up session, which ranged from 8 to 20 months. Results: The mean size of the OTLs was 1.16cm2, and “Raikin-4” was the most common site of lesions (71%). Calcaneal osteotomy was the mostcommonly associated procedure (18%). The mean follow-up period was 12.3 months. The mean AOFAS score before surgery was 46.4 points, rising to 89.5 points at the last follow-up, and this difference was statistically significant (p<0.001). No complications were observed in any of the treated patients. Conclusion: AT-AMIC® is a reliable and reproducible treatment method for OTLs and achieves high postoperative clinical scores with very low complication rates. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Minimal invasive percutaneous nephrolithotomy (Mini-PCNL) in children: Ultrasound versus fluoroscopic guidance

2021 ◽  
Vol 93 (2) ◽  
pp. 173-177
Author(s):  
Ali Eslahi ◽  
Faisal Ahmed ◽  
Mohammad Mehdi Hosseini ◽  
Mohammad Reza Rezaeimehr ◽  
Nazanin Fathi ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Previous History ◽  
Minimal Invasive ◽  
Complication Rates ◽  
Procedural Information ◽  
Hemodynamic State ◽  
History Of ◽  
The Mean ◽  
Retrospective Comparative Study

Background: Miniaturization of endoscopic instruments in percutaneous nephrolithotomy (PCNL) allowed less invasive procedures with low complication rates, especially in children. This study was conducted to evaluate the safety and efficacy of ultrasonography-guided (USG) versus fluoroscopy-guided (FG) mini-PCNL in children.Materials and methods: This is a retrospective comparative study conducted from June 2015 to June 2020. The sample included 70 children (35 pateints underwent USG mini-PCNL and 35 pateints underwent FG mini-PCNL). They were compared mainly by the patients’ demographic characteristics, procedural information, and post-treatment outcomes. In the USG mini-PCNL group, puncturing was performed using a 3.5 MHz US probe, whereas fluoroscopy was utilized in the FG mini- PCNL group. Results: Both groups were comparable in terms of gender, previous history of failed ESWL, and hydronephrosis grade. The mean stone burden was 15.94 ± 3.69 mm and 19.20 ± 7.41 mm in USG and FG groups, respectively (p = 0.024). The stonefree rate (SFR) was 97.1% in the USG group and 94.3% in the FG group, which was not statistically significant (p = 0.16). Mean operative time in the USG group and FG group was 69.00 ± 13.33 minutes and 63.48 ± 16.90 minutes, respectively. Four (11.4%) patients in the FG group required blood transfusions to restore the hemodynamic state (p = 0.039). Fever was detected in 4 (11.4%) patients in the USG group and 15 (31.4%) patients in the FG group (p = 0.041). Conclusions: In children, mini PCNL under USG is safe and as effective as fluoroscopy.

Results of 1940 embolizations for dural arteriovenous fistulas: Japanese Registry of Neuroendovascular Therapy (JR-NET3)

2020 ◽  
Vol 133 (1) ◽  
pp. 166-173 ◽  
Author(s):  
Masafumi Hiramatsu ◽  
Kenji Sugiu ◽  
Tomohito Hishikawa ◽  
Shingo Nishihiro ◽  
Naoya Kidani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Data Extraction ◽  
Transarterial Embolization ◽  
Complication Rates ◽  
Multicenter Observational Study ◽  
Arteriovenous Fistulas ◽  
Emergency Procedures ◽  
Dural Arteriovenous Fistulas ◽  
Nature Frequency ◽  
Independent Risk Factors

OBJECTIVEEmbolization is the most common treatment for dural arteriovenous fistulas (dAVFs). A retrospective, multicenter observational study was conducted in Japan to clarify the nature, frequency, and risk factors for complications of dAVF embolization.METHODSPatient data were derived from the Japanese Registry of Neuroendovascular Therapy 3 (JR-NET3). A total of 40,169 procedures were registered in JR-NET3, including 2121 procedures (5.28%) in which dAVFs were treated with embolization. After data extraction, the authors analyzed complication details and risk factors in 1940 procedures performed in 1458 patients with cranial dAVFs treated with successful or attempted embolization.RESULTSTransarterial embolization (TAE) alone was performed in 858 cases (44%), and transvenous embolization (TVE) alone was performed in 910 cases (47%). Both TAE and TVE were performed in one session in 172 cases (9%). Complications occurred in 149 cases (7.7%). Thirty-day morbidity and mortality occurred in 55 cases (2.8%) and 16 cases (0.8%), respectively. Non–sinus-type locations, radical embolization as the strategy, procedure done at a hospital that performed dAVF embolization in fewer than 10 cases during the study period, and emergency procedures were independent risk factors for overall complications.CONCLUSIONSComplication rates of dAVF embolization in Japan were acceptable. For better results, the risk factors identified in this study should be considered in treatment decisions.

Batch Precipitation of Lead Iodide

1994 ◽  
Vol 59 (6) ◽  
pp. 1301-1304
Author(s):  
Jaroslav Nývlt ◽  
Stanislav Žáček
Keyword(s):  
Aqueous Solution ◽  
Particle Size ◽  
Particle Size Distribution ◽  
Size Distribution ◽  
Crystal Size ◽  
Lead Nitrate ◽  
Lead Iodide ◽  
Constant Rate ◽  
Mean Size ◽  
The Mean

Lead iodide was precipitated by a procedure in which an aqueous solution of potassium iodide at a concentration of 0.03, 0.10 or 0.20 mol l-1 was stirred while an aqueous solution of lead nitrate at one-half concentration was added at a constant rate. The mean size of the PbI2 crystals was determined by evaluating the particle size distribution, which was measured sedimentometrically. The dependence of the mean crystal size on the duration of the experiment exhibited a minimum for any of the concentrations applied. The reason for this is discussed.

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