Use of an angiographic catheter to facilitate fluoroscopy-guided percutaneous renal access in cases with diffuse contrast extravasation.
OBJECTIVE
Occasionally during percutaneous surgery, significant contrast extravasation obscures the field, making fluoroscopic access no longer feasible. Herein, we describe a salvage technique.


METHODS
The cystoscopically placed, open-end ureteral catheter is exchanged with an angled-tip angiographic catheter. With the aid of a guidewire and under fluoroscopic guidance, the tip of the catheter is placed in a posterior calix. The "bull's eye" technique is then applied to direct the needle into the tip of the catheter. This technique was used in four cases over a 7-year period.


RESULTS
Successful access was accomplished in all cases through a middle or upper calix.


CONCLUSIONS
The catheter serves as a target for providing access to the renal collecting system and facilitates final tract dilatation.
Giannakopoulos
Stilianos
S
Department of Urology, Democritus University of Thrace, Alexandroupolis, Greece. stgian@otenet.gr
Bantis
Athanasios
A
Kalaitzis
Christos
C
Touloupidis
Stavros
S
D000792:Angiography / Q000295:instrumentation; D057785:Catheters; D004867:Equipment Design; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000517:prevention & control; D005471:Fluoroscopy; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D014513:Ureter; D014546:Urinary Catheterization / Q000295:instrumentation; D013520:Urologic Surgical Procedures / Q000379:methods*