title: Endovascular management of vascular complications after percutaneous nephrolithotomy.
abstract: BACKGROUND
  Bleeding is one of the most common and most important complications of percutaneous nephrolithotomy (PCNL), which is mainly controlled with conservative treatment options. Transcatheter arterial embolization is required in less than 1 % of the patients undergoing PCNL. There are only a few studies about endovascular treatment of vascular complications of PCNL. The purpose of this study was to evaluate renal arterial complications of PCNL and treatment outcomes with endovascular coil embolization.
  
  
  METHODS
  This retrospective study evaluated 16 patients who underwent endovascular management for complications after PCNL, including diagnostic angiography. We analyzed the angiographic appearances of the vascular lesions that caused hemorrhages, treatment outcomes for endovascular coil embolization, and renal parenchymal loss rate following this treatment.
  
  
  RESULTS
  Seven patients had a pseudoaneurysm, two patients had an arteriocaliceal fistula (ACF), five patients had a pseudoaneurysm and an arteriovenous fistula (AVF), and two patients had a pseudoaneurysm and an ACF. Of the 14 patients with pseudoaneurysms, five had more than one pseudoaneurysm. Endovascular coil embolization was successful in all patients, and it was able to stop the bleeding. After embolization, 12 patients had less than 10 % parenchymal loss, and 4 patients had 10-20 % parenchymal loss. Mean hospital stay after embolization was 2.3 ± 0.7 days (range, 1 to 3 days).
  
  
  CONCLUSIONS
  The injuries seen in the intrarenal arterial system during the PCNL procedure can result in pseudoaneurysms and/or AVFs and/or ACFs, and more than one artery can be harmed. Arterial complications of PCNL can be treated with endovascular coil embolization while preserving renal function at a maximum level.
authors.affiliation: Gaziantep University, Faculty of Medicine Gaziantep, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Kervancioglu
authors.affiliation: Inayet Topcuoglu Medical Center, Turkey.
authors.forename: Feyza
authors.initials: F
authors.lastname: Gelebek Yilmaz
authors.affiliation: Gaziantep University, Faculty of Medicine Gaziantep, Turkey.
authors.forename: Sakip
authors.initials: S
authors.lastname: Erturhan
mesh_terms: D000293:Adolescent; D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002648:Child; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007670:Kidney Calices / Q000000981:diagnostic imaging / Q000293:injuries*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D055815:Young Adult
keywords: Percutaneous nephrolithotomy; embolization; hemorrhage