Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report

<p>Abstract</p> <p>Introduction</p> <p>Intrarenal pseudoaneurysm is a rare, yet clinically significant, complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order to recognize pseudoaneurysm as the cause of delayed bleeding af...

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Main Authors: Wazait Hassan, El-Husseiny Tamer, Moraitis Konstantinos, Philippou Prodromos, Masood Junaid, Buchholz Noor
Format: Article
Language:English
Published: BMC 2010-09-01
Series:Journal of Medical Case Reports
Online Access:http://www.jmedicalcasereports.com/content/4/1/316
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author Wazait Hassan
El-Husseiny Tamer
Moraitis Konstantinos
Philippou Prodromos
Masood Junaid
Buchholz Noor
author_facet Wazait Hassan
El-Husseiny Tamer
Moraitis Konstantinos
Philippou Prodromos
Masood Junaid
Buchholz Noor
author_sort Wazait Hassan
collection DOAJ
description <p>Abstract</p> <p>Introduction</p> <p>Intrarenal pseudoaneurysm is a rare, yet clinically significant, complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order to recognize pseudoaneurysm as the cause of delayed bleeding after percutaneous nephrolithotomy and angiography confirms the diagnosis which allows endovascular management.</p> <p>Case presentation</p> <p>We present a case of a 65-year old Caucasian woman who underwent percutaneous nephrolithotomy in the supine position for a two centimetre renal calculus. The postoperative course was complicated by persistent bleeding due to a renal pseudoaneurysm. The vascular lesion was successfully managed by endovascular exclusion through the use of a covered stent graft. We report the first successful use of this method for the management of iatrogenic pseudoaneurysm in a branch of the left renal artery and we focus on the imaging findings, technical details, advantages and limitations of this technique.</p> <p>Conclusion</p> <p>As a result of its high efficacy, interventional radiology has largely replaced open surgery for the management of renal pseudoaneurysm related to percutaneous nephrolithotomy. Recent technical advancements have allowed the use of covered stent grafts as an alternative to embolisation for the angiographic management of visceral artery pseudoaneurysm located in other organs. This novel technique allows the endovascular exclusion of the pseudoaneurysm, without compromising arterial supply to the end-structures - an advantage of critical importance in organs supplied by segmental arteries - in the absence of collateral vasculature, such as the kidney.</p>
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spelling doaj.art-bb93240d1a3247fcb459e56fdf9a23442022-12-21T18:34:50ZengBMCJournal of Medical Case Reports1752-19472010-09-014131610.1186/1752-1947-4-316Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case reportWazait HassanEl-Husseiny TamerMoraitis KonstantinosPhilippou ProdromosMasood JunaidBuchholz Noor<p>Abstract</p> <p>Introduction</p> <p>Intrarenal pseudoaneurysm is a rare, yet clinically significant, complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order to recognize pseudoaneurysm as the cause of delayed bleeding after percutaneous nephrolithotomy and angiography confirms the diagnosis which allows endovascular management.</p> <p>Case presentation</p> <p>We present a case of a 65-year old Caucasian woman who underwent percutaneous nephrolithotomy in the supine position for a two centimetre renal calculus. The postoperative course was complicated by persistent bleeding due to a renal pseudoaneurysm. The vascular lesion was successfully managed by endovascular exclusion through the use of a covered stent graft. We report the first successful use of this method for the management of iatrogenic pseudoaneurysm in a branch of the left renal artery and we focus on the imaging findings, technical details, advantages and limitations of this technique.</p> <p>Conclusion</p> <p>As a result of its high efficacy, interventional radiology has largely replaced open surgery for the management of renal pseudoaneurysm related to percutaneous nephrolithotomy. Recent technical advancements have allowed the use of covered stent grafts as an alternative to embolisation for the angiographic management of visceral artery pseudoaneurysm located in other organs. This novel technique allows the endovascular exclusion of the pseudoaneurysm, without compromising arterial supply to the end-structures - an advantage of critical importance in organs supplied by segmental arteries - in the absence of collateral vasculature, such as the kidney.</p>http://www.jmedicalcasereports.com/content/4/1/316
spellingShingle Wazait Hassan
El-Husseiny Tamer
Moraitis Konstantinos
Philippou Prodromos
Masood Junaid
Buchholz Noor
Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report
Journal of Medical Case Reports
title Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report
title_full Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report
title_fullStr Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report
title_full_unstemmed Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report
title_short Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report
title_sort endovascular covered stenting for the management of post percutaneous nephrolithotomy renal pseudoaneurysm a case report
url http://www.jmedicalcasereports.com/content/4/1/316
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