UroToday – In this award winning manuscript, the authors review the incidence, cause, and diagnosis of vascular complications in more than a score of experience with percutaneous renal surgery in 4,695 patients.

The incidence of hemorrhagic complications was highest among patients undergoing percutaenous resection of an upper tract transitional cell cancer (3.8%); for percutaneous stone removal or percutaneous endopyelotomy, the incidence was only 1.2% and 0.8% respectively.

Among the most recent patients (2495), angiography was diagnostic in 98%. The most common diagnosis by a factor of two was pseudoaneurysm followed by artierovenous malformation. Overall angiographic embolization was successful in 95%; three patients (0.06%) required open exploration. Of note, 17.5% of patients had more than one angiographic finding.

In my mind, this represents the most comprehensive treatment of this topic to date.

Richstone L, Reggio E, Ost MC, Seideman C, Fossett LK, Okeke Z, Rastinehad AR, Lobko I, Siegel DN, Smith AD.
J Endourol. 2008 Jun;22(6):1129-35.
doi:10.1089/end.2008.0061

UroToday Medical Editor Ralph V. Clayman, MD

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