title: Safety and Feasibility of Salvage Endoscopic Combined Intrarenal Surgery in Embolized Kidney.
abstract: BACKGROUND
  Although endoscopic combined intrarenal surgery (ECIRS) is well established as primary approach to complex lithiasis, no evidences are still available on its use in salvage context.
  
  
  METHODS
  A male patient, of 55 years of age, underwent many unsuccessful surgical procedures to treat large and multiple right kidney stones, including percutaneous nephrolithotomy (PCNL). The latter was complicated by severe postoperative hemorrhage, managed with super-selective renal artery embolization (SRAE). Therefore he came to our institution to achieve a complete resolution of the urolithiasis. Preoperative evaluation included CT scan and renal scintigraphy to establish kidney and stone morphologic features and residual renal function. Salvage ECIRS was performed and postoperative assessment showed a complete resolution of lithiasis and absence of renal function impairment.
  
  
  CONCLUSIONS
  To our knowledge, this is the first case of salvage ECIRS reported in literature after previous failed PCNL. Even after SRAE, this procedure appears as safe and as efficacious as standard salvage PCNL when performed by experienced hands.
authors: Department of Urology, Vittorio Emanuele Hospital , Catania, Italy .
authors: Alfonso
authors: A
authors: Benincasa
authors: Department of Urology, Vittorio Emanuele Hospital , Catania, Italy .
authors: Federico
authors: F
authors: Nicolosi
authors: Department of Urology, Humanitas Clinical and Research Center, Humanitas University , Rozzano, Italy .
authors: Giovanni
authors: G
authors: Lughezzani
authors: Department of Urology, Humanitas Clinical and Research Center, Humanitas University , Rozzano, Italy .
authors: Nicolò Maria
authors: NM
authors: Buffi
authors: Department of Urology, Humanitas Clinical and Research Center, Humanitas University , Rozzano, Italy .
authors: Paolo
authors: P
authors: Casale
authors: Department of Urology, Humanitas Clinical and Research Center, Humanitas University , Rozzano, Italy .
authors: Rodolfo
authors: R
authors: Hurle
authors: Department of Urology, Humanitas Clinical and Research Center, Humanitas University , Rozzano, Italy .
authors: Massimo
authors: M
authors: Lazzeri
authors: Department of Urology, Humanitas Clinical and Research Center, Humanitas University , Rozzano, Italy .
authors: Pasquale
authors: P
authors: Cardone
authors: Department of Urology, Humanitas Clinical and Research Center, Humanitas University , Rozzano, Italy .
authors: Giorgio
authors: G
authors: Guazzoni
authors: Department of Urology, Humanitas Clinical and Research Center, Humanitas University , Rozzano, Italy .
authors: Alberto
authors: A
authors: Saita