title: Severe bleeding after nephrolithotomy: results of hyperselective embolization.
abstract: From 1984 to 1998, 808 patients underwent percutaneous nephrolithotomy for removal of renal calculi. Although the technique is safe and effective, complications, including hemorrhages, have been reported. Eight patients (1%) are described in whom severe bleeding following percutaneous nephrolithotomy was uncontrolled by usual methods and treated by hyperselective embolization. Renal arteriography has shown arteriovenous fistula in 3 patients, pseudo aneurysm in 4 and both in1 patient. Embolization allowed definitive treatment of these lesions in 7 of our 8 patients. The failure of embolization in 1 patient imposed a partial nephrectomy. Patients with normal renal function did not suffer significant change in the serum creatinine after treatment (percutaneous nephrolithotomy + embolization), and all but 1 patient have maintained normal blood pressure. In the authors' opinion, hyperselective embolization is the least invasive and best treatment for massive hemorrhage after percutaneous nephrolithotomy.
authors.affiliation: Urology, Edouard Herriot'sHospital, Lyon, France.
authors.forename: X
authors.initials: X
authors.lastname: Martin
authors.forename: F J
authors.initials: FJ
authors.lastname: Murat
authors.forename: L C
authors.initials: LC
authors.lastname: Feitosa
authors.forename: O
authors.initials: O
authors.lastname: Rouvière
authors.forename: D
authors.initials: D
authors.lastname: Lyonnet
authors.forename: A
authors.initials: A
authors.lastname: Gelet
authors.forename: J
authors.initials: J
authors.lastname: Dubernard
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery; D007674:Kidney Diseases / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000628:therapy*; D012720:Severity of Illness Index