Intermittent quick-check CT fluoroscopy-guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections: 11-year experience
PURPOSEWe aimed to evaluate technical and clinical success and safety of computed tomography fluoroscopy (CTF)-guided percutaneous pigtail drainage (PPD) placement in patients with infected renal and perirenal fluid collections.METHODSThis retrospective analysis comprised 44 patients (52.27% men; ag...
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2021-05-01
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| Series: | Diagnostic and Interventional Radiology |
| Online Access: |
http://www.dirjournal.org/archives/archive-detail/article-preview/ntermittent-quick-check-ct-fluoroscopy-guided-perc/54346
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| _version_ | 1797691391385534464 |
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| author | Christoph G. Trumm Caroline Burgard Constanze Deger Robert Stahl Robert Forbrig Melvin D'Anastasi |
| author_facet | Christoph G. Trumm Caroline Burgard Constanze Deger Robert Stahl Robert Forbrig Melvin D'Anastasi |
| author_sort | Christoph G. Trumm |
| collection | DOAJ |
| description | PURPOSEWe aimed to evaluate technical and clinical success and safety of computed tomography fluoroscopy (CTF)-guided percutaneous pigtail drainage (PPD) placement in patients with infected renal and perirenal fluid collections.METHODSThis retrospective analysis comprised 44 patients (52.27% men; age, 57.1±18.5 years) undergoing low-milliampere (10–20 mA) CTF-guided PPD placement in 61 sessions under local anesthesia from August 2005 to November 2016. Infected fluid collections (n=71) included infected renal cysts (12.68%), renal and perirenal abscesses due to comorbidities (23.94%), or fluid collections after renal surgery or urological intervention (63.38%). Technical success was defined as PPD placement with consecutive fluid aspiration, clinical success as normalization or marked improvement of clinical symptoms (e.g., flank pain, fever) and inflammatory parameters (leukocyte count, C-reactive protein) after minimally invasive combination therapy (intravenous broad-spectrum antibiotics and drainage). Complications were classified according to the CIRSE classification.RESULTSOverall, 73 single lumen PPD (7.5–12 F) were utilized (1 PPD per session, 69.86%; 2 PPD per session, 15.07%). In 4 cases, PPD could not be inserted into the fluid collection (4.11%) or could not be aspirated (1.37%), yielding overall 94.5% primary technical success. Mean duration of functioning PPD before removal was 10.9 days. Adverse events within 30 days comprised PPD failure (2.27%) or secondary dislocation (Grade 3, 11.36%) and one death (Grade 6, unrelated to intervention, 2.27%). Additional invasive measures after primary CTF-guided PPD were required in 5 patients (nephrectomy 6.82%, partial nephrectomy 2.27%, surgical drainage 2.27%). Thus, clinical success using only minimally invasive measures was achieved in 39 of 44 patients (88.64%).CONCLUSIONGiven a minor proportion of patients requiring surgical revision, combined antibiotics and CTF-guided PPD of infected renal and perirenal fluid collections provides an excellent technical and clinical outcome. |
| first_indexed | 2024-03-12T02:12:38Z |
| format | Article |
| id | doaj.art-e582887d5f784cd9afe94663c03829fc |
| institution | Directory Open Access Journal |
| issn | 1305-3825 1305-3612 |
| language | English |
| last_indexed | 2024-03-12T02:12:38Z |
| publishDate | 2021-05-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Diagnostic and Interventional Radiology |
| spelling | doaj.art-e582887d5f784cd9afe94663c03829fc2023-09-06T12:21:06ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122021-05-0127337838510.5152/dir.2021.2006813049054Intermittent quick-check CT fluoroscopy-guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections: 11-year experienceChristoph G. Trumm0Caroline Burgard1Constanze Deger2Robert Stahl3Robert Forbrig4Melvin D'Anastasi5 Institute for Diagnostic and Interventional Neuroradiology, Ludwig-Maximilians-University of Munich, Munich, Germany Department of Radiology, Ludwig-Maximilians-University of Munich, Munich, Germany Department of Radiology, Ludwig-Maximilians-University of Munich, Munich, Germany Institute for Diagnostic and Interventional Neuroradiology, Ludwig-Maximilians-University of Munich, Munich, Germany Institute for Diagnostic and Interventional Neuroradiology, Ludwig-Maximilians-University of Munich, Munich, Germany Medical Imaging Department, Mater Dei Hospital, Triq tal-Qroqq, Msida, Malta PURPOSEWe aimed to evaluate technical and clinical success and safety of computed tomography fluoroscopy (CTF)-guided percutaneous pigtail drainage (PPD) placement in patients with infected renal and perirenal fluid collections.METHODSThis retrospective analysis comprised 44 patients (52.27% men; age, 57.1±18.5 years) undergoing low-milliampere (10–20 mA) CTF-guided PPD placement in 61 sessions under local anesthesia from August 2005 to November 2016. Infected fluid collections (n=71) included infected renal cysts (12.68%), renal and perirenal abscesses due to comorbidities (23.94%), or fluid collections after renal surgery or urological intervention (63.38%). Technical success was defined as PPD placement with consecutive fluid aspiration, clinical success as normalization or marked improvement of clinical symptoms (e.g., flank pain, fever) and inflammatory parameters (leukocyte count, C-reactive protein) after minimally invasive combination therapy (intravenous broad-spectrum antibiotics and drainage). Complications were classified according to the CIRSE classification.RESULTSOverall, 73 single lumen PPD (7.5–12 F) were utilized (1 PPD per session, 69.86%; 2 PPD per session, 15.07%). In 4 cases, PPD could not be inserted into the fluid collection (4.11%) or could not be aspirated (1.37%), yielding overall 94.5% primary technical success. Mean duration of functioning PPD before removal was 10.9 days. Adverse events within 30 days comprised PPD failure (2.27%) or secondary dislocation (Grade 3, 11.36%) and one death (Grade 6, unrelated to intervention, 2.27%). Additional invasive measures after primary CTF-guided PPD were required in 5 patients (nephrectomy 6.82%, partial nephrectomy 2.27%, surgical drainage 2.27%). Thus, clinical success using only minimally invasive measures was achieved in 39 of 44 patients (88.64%).CONCLUSIONGiven a minor proportion of patients requiring surgical revision, combined antibiotics and CTF-guided PPD of infected renal and perirenal fluid collections provides an excellent technical and clinical outcome. http://www.dirjournal.org/archives/archive-detail/article-preview/ntermittent-quick-check-ct-fluoroscopy-guided-perc/54346 |
| spellingShingle | Christoph G. Trumm Caroline Burgard Constanze Deger Robert Stahl Robert Forbrig Melvin D'Anastasi Intermittent quick-check CT fluoroscopy-guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections: 11-year experience Diagnostic and Interventional Radiology |
| title | Intermittent quick-check CT fluoroscopy-guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections: 11-year experience |
| title_full | Intermittent quick-check CT fluoroscopy-guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections: 11-year experience |
| title_fullStr | Intermittent quick-check CT fluoroscopy-guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections: 11-year experience |
| title_full_unstemmed | Intermittent quick-check CT fluoroscopy-guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections: 11-year experience |
| title_short | Intermittent quick-check CT fluoroscopy-guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections: 11-year experience |
| title_sort | intermittent quick check ct fluoroscopy guided percutaneous drainage placement in patients with infected renal and perirenal fluid collections 11 year experience |
| url |
http://www.dirjournal.org/archives/archive-detail/article-preview/ntermittent-quick-check-ct-fluoroscopy-guided-perc/54346
|
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