title: Analysis of repeated renal arteriography after percutaneous nephrolithotomy.
abstract: To review the clinical data of the patients who required repeated renal arteriography following initial super-selective renalartery embolization (SRAE) after Percutaneous Nephrolithotomy (PCNL) and to analyze the reasons for the failure. We retrospectively reviewed the data of the patients who underwent repeat renal arteriography after PCNL for persistent or recurrent severe hemorrhage from August 2001 through August 2015 at our hospital. Total of 427 SRAEs were performed in 369 patients who had undergone PCNL. 21 patients had repeated renal arteriography. Among them, 12 required 2 sessions, 5 required 3 sessions, 1 required 4 sessions, and 3 required 5 sessions. In those 37 repeated renal arteriography, 7 were due to missed pseudoaneurysm, 5 for recanalization of the embolized vessels, and finding of new renal vascular lesions in 22. These new findings included new pseudoaneurysm in sixteen, new arterio-venous fistula (AVF) in two, combination of new pseudoaneurysm and AVF in four, and no identifiable abnormity in three. Except for the missed pseudoaneurysm and the recanalization of the embolized vessels, new renal vascular lesion was the major reason for the repeated arteriography in our hospital. The cause of these new renal vascular lesions was unknown. The lesion might be missed during the initial arteriography due to arterial spasm. Progressive deterioration of the injured vessel integrity could be the other possibility.
authors.affiliation: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of the Guangzhou Medical University, Guangzhou, Guangdong, China. gzgyhzh@163.com.|Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China. gzgyhzh@163.com.|, Kangda Road #1, Haizhou Distritct, Guangzhou, 510230, Guangdong, China. gzgyhzh@163.com.
authors.forename: He
authors.initials: H
authors.lastname: Zhaohui
authors.affiliation: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of the Guangzhou Medical University, Guangzhou, Guangdong, China.|Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Hanqi
authors.affiliation: Department of Urology, The Second Hospital Affiliated to Nanchang University, Nanchang, Jiangxi, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Xiongbing
authors.affiliation: Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Caixia
authors.affiliation: Department of Urology, Chinese-American Stone Center, The First People's Hospital of Xiaoshan, Hangzhou, Zhejiang, China.
authors.forename: Wan
authors.initials: W
authors.lastname: Shawpong
authors.affiliation: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of the Guangzhou Medical University, Guangzhou, Guangdong, China.|Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, China.
authors.forename: Zeng
authors.initials: Z
authors.lastname: Guohua
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology; D000792:Angiography / Q000706:statistics & numerical data*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000601:surgery*; D000074642:Nephrolithotomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D012008:Recurrence; D012077:Renal Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D017211:Treatment Failure
keywords: Arterio-venous fistula (AVF); Percutaneous nephrolithotomy (PCNL); Super-selective renalartery embolization (SRAE)