tailieunhanh - báo cáo khoa học: " Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm: a case report | Philippou et al. Journal of Medical Case Reports 2010 4 316 http content 4 1 316 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Endovascular covered stenting for the management of post-percutaneous nephrolithotomy renal pseudoaneurysm a case report Prodromes Philippou Konstantinos Moraitis Tamer El-Husseiny Hassan Wazait Junaid Masood Noor Buchholz Abstract Introduction Intrarenal pseudoaneurysm is a rare yet clinically significant complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order to recognize pseudoaneurysm as the cause of delayed bleeding after percutaneous nephrolithotomy and angiography confirms the diagnosis which allows endovascular management. Case presentation We present a case of a 65-year old Caucasian woman who underwent percutaneous nephrolithotomy in the supine position for a two centimetre renal calculus. The postoperative course was complicated by persistent bleeding due to a renal pseudoaneurysm. The vascular lesion was successfully managed by endovascular exclusion through the use of a covered stent graft. We report the first successful use of this method for the management of iatrogenic pseudoaneurysm in a branch of the left renal artery and we focus on the imaging findings technical details advantages and limitations of this technique. Conclusion As a result of its high efficacy interventional radiology has largely replaced open surgery for the management of renal pseudoaneurysm related to percutaneous nephrolithotomy. Recent technical advancements have allowed the use of covered stent grafts as an alternative to embolisation for the angiographic management of visceral artery pseudoaneurysm located in other organs. This novel technique allows the endovascular exclusion of the pseudoaneurysm without compromising arterial supply to the end-structures - an advantage of critical importance in organs supplied by segmental arteries - in the absence of .