Percutaneous antegrade removal of double J ureteral stents via a 9-F nephrostomy route.
OBJECTIVE
To evaluate the safety and clinical efficacy of an antegrade approach in the removal of double J ureteral stents via preexisting nondilated nephrostomy routes under fluoroscopic guidance.


METHODS
Under fluoroscopic guidance and local anesthesia, antegrade removal of 39 ureteral stents in 27 patients was attempted by using a snare or basket. Indications for percutaneous stent removal included the presence of a preexisting nephrostomy route (n = 8), a surgical history resulting in an inaccessible retrograde route (n = 8), urethral stricture (n = 5), upward stent migration (n = 2), inability to obtain a lithotomy position (n = 1), fragmentation of the proximal stent (n = 1), and inability to find the ureteral orifice with a cystoscope (n = 2).


RESULTS
Thirty-seven of the 39 stents (95%) were successfully removed by using a snare or basket. Two stents (5.1%) could not be removed with a snare or basket because they were embedded against the renal calyx or pelvis. There were no major complications. Blood clot formation or laceration or tract leakage of the pelvicalyceal system occurred in six and two patients, respectively, all of which resolved spontaneously.


CONCLUSIONS
Percutaneous antegrade removal of double J ureteral stents with a snare or basket via a nondilated nephrostomy route is effective without major complications in patients with an available nephrostomy route or an inaccessible retrograde option.
Shin
Ji Hoon
JH
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, Korea. jhshin@amc.seoul.kr
Yoon
Hyun-Ki
HK
Ko
Gi-Young
GY
Sung
Kyu-Bo
KB
Song
Ho-Young
HY
Choi
Eugene
E
Kim
Jin Hyoung
JH
Kim
Jae Wook
JW
Kim
Kyung-Rae
KR
Kwon
Jaehyun
J
D000328:Adult; D000368:Aged; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods; D015607:Stents; D014513:Ureter / Q000000981:diagnostic imaging* / Q000601:surgery*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging* / Q000628:therapy*; D014567:Urography / Q000379:methods