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  • Title: [Characteristics of renal hemorrhage after percutaneous nephrolithotomy and the timing of selective embolization: a report of 13 cases].
    Author: Xiong LL, Huang XB, Ye XJ, Li JX, Yang B, Xu QQ, Ma K, Chen L, Wang XF, Gao J, Jin L, Chen L.
    Journal: Beijing Da Xue Xue Bao Yi Xue Ban; 2010 Aug 18; 42(4):465-8. PubMed ID: 20721266.
    Abstract:
    OBJECTIVE: To investigate the characteristics of severe renal hemorrhage after percutaneous nephrolithotomy (PNL) and timing of selective transarterial embolization(TAE) . METHODS: Between May 2005 and March 2010, superselective renal angiography was used to control severe bleeding in 15 of 1418 cases (1520 PNL procedures, 1.06%). In the 15 cases, superselective renal angioembolization was used to control severe bleeding in 13 (0.92%) . The medical records of all the patients who underwent renal angiography and angioembolization were reviewed. RESULTS: Severe bleeding cases after PNL were divided into 3 types according to the clinical characteristics: type I (urgency type), type II (intermittence type) and type III (persistent slow type). There were 3 patients in type I, 6 in type II and 6 in type III. All the patients had a normal coagulation profile before surgery. A total of 11 patients (84.6%) underwent the first-time successful embolization and 2 (15.4%) the second-time successful embolization. The longer time between angioembolization and bleeding was, the more blood loss and transfusion volume were, except for 1 patient in type II . Temporality serum creatinine abnormality was found in 2 patients, one with a solitary kidney patient and the other with angioembolization for both renal bleeding. CONCLUSION: TAE is a minimally invasive, safe, simple, and highly effective modality for the management of post PNL renal bleeding. This option should be considered early in the management of these cases,especially for Urgency type bleeding.
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