Eadie Erik, Harmon Taylor S, Soule Erik, Hulsberg Paul C, Shabandi Michael, Matteo Jerry
Interventional Radiology, University of Florida College of Medicine, Jacksonville, USA.
Interventional Radiology, The University of Texas Medical Branch, Galveston, USA.
Cureus. 2018 Oct 19;10(10):e3469. doi: 10.7759/cureus.3469.
The percutaneous nephrostomy (PCN) is a relatively common interventional procedure used to treat a multitude of nephro-urological conditions. Traditionally, interventional radiologists use ultrasound guidance, needles, catheters, and guidewires to access the collecting system percutaneously. The placement of a nephro-ureterostomy stent may be precluded by challenging renal calyx anatomy or an underlying disease process that obstructs placement. In cases of complex obstruction, accessing the renal collecting system may require deviation from conventional methods. We present a case that after many failed attempts with a wide variety of guidewires and catheters, a steerable microcatheter (SMC) was used to safely and effectively access the renal collecting system. This novel technique utilizes the SMC to efficiently achieve complicated PCN stent placement, relieving the renal drainage system obstruction and potentially minimizing or avoiding complications, such as urosepsis and/or renal failure.
经皮肾造瘘术（PCN）是一种相对常见的介入手术，用于治疗多种肾泌尿系统疾病。传统上，介入放射科医生使用超声引导、穿刺针、导管和导丝经皮进入集合系统。肾输尿管造口支架的放置可能会因具有挑战性的肾盏解剖结构或妨碍放置的潜在疾病过程而受到阻碍。在复杂梗阻的情况下，进入肾集合系统可能需要偏离传统方法。我们报告一例病例，在使用各种导丝和导管多次尝试失败后，使用了可操纵微导管（SMC）安全有效地进入肾集合系统。这项新技术利用SMC有效地完成复杂的PCN支架置入，缓解肾引流系统梗阻，并可能将诸如尿脓毒症和/或肾衰竭等并发症降至最低或避免并发症的发生。
