Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Int J Clin Pract. 2022 May 17;2022:4422547. doi: 10.1155/2022/4422547. eCollection 2022.
To evaluate the clinical characteristics and angiographic features of transcatheter angiographic embolization (TAE) in patients with active bleeding after percutaneous nephrolithotomy (PCNL).
Between 2009 and 2018, 45 patients who underwent TAE for hemorrhage control after PCNL were reviewed retrospectively. Patient clinical characteristics and angiographic features of TAE were analyzed.
Of the 3148 patients, 45 (1.4%) patients were treated with TAE after PCNL. The interval from the bleeding episode to TAE was 3 days (1,6). Arterial laceration, arteriovenous fistula, and negative angiographic finding were found in 28 (62.2%), 7 (15.6%), and 10 patients (22.2%). Thirty-five patients (92.1%) achieved primary clinical success. The median-corrected hemoglobin decrease from bleeding episode to TAE was 52 g/L (25.25, 71.00). The median-corrected hemoglobin decrease rate from bleeding episode to TAE was 13.11 g/L·d (5.60, 26.12). The hemoglobin decrease from bleeding episode to TAE was lesser in negative angiographic patients (28.50 (10.75,51.25) g/L VS 53.7 (35.0,73.13) g/L) than in positive angiographic patients ( < 0.05).
TAE is a safe and effective treatment for post-PCNL bleeding patients. Previous kidney surgery is associated with a higher risk of TAE. Patients with bleeding from multiple negative angiographic findings can be considered for prophylactic embolization.
评估经皮肾镜取石术后（PCNL）后活动性出血患者的经导管血管造影栓塞（TAE）的临床特征和血管造影特征。
回顾性分析 2009 年至 2018 年间，45 例因 PCNL 后出血而行 TAE 控制出血的患者。分析患者的临床特征和 TAE 的血管造影特征。
在 3148 例患者中，45 例（1.4%）患者在 PCNL 后接受了 TAE 治疗。从出血到 TAE 的时间间隔为 3 天（1 到 6）。28 例（62.2%）、7 例（15.6%）和 10 例（22.2%）患者发现动脉撕裂、动静脉瘘和阴性血管造影。35 例（92.1%）患者达到了主要临床成功。从出血到 TAE 的校正血红蛋白降低中位数为 52g/L（25.25，71.00）。从出血到 TAE 的校正血红蛋白降低率中位数为 13.11g/L·d（5.60，26.12）。阴性血管造影患者从出血到 TAE 的血红蛋白降低量（28.50（10.75，51.25）g/L 比阳性血管造影患者（35.0，73.13）g/L）较小（<0.05）。
TAE 是治疗 PCNL 后出血患者的一种安全有效的治疗方法。既往肾脏手术与 TAE 风险增加相关。对于有多个阴性血管造影发现的出血患者，可以考虑预防性栓塞。
