Meng Xianghu, Cong Rong, Hua Yibo, Wang Zengjun, Song Ninghong, Yang Wei, Song Rijin
Department of Urology, First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Department of Interventional Radiology, First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Front Surg. 2025 Jan 13;11:1429821. doi: 10.3389/fsurg.2024.1429821. eCollection 2024.
There is no systematic classification of renal vascular injuries conducted for severe post-percutaneous nephrolithotomy (PCNL) bleeding.
The aim of the present study was to explore the various types of artery injury and clinical characteristics of patients who underwent transcatheter angioembolization (TAE) after PCNL.
A retrospective analysis was performed on 52 patients who underwent renal arteriography (RA) because of severe bleeding after PCNL between April 2009 and December 2023. Among the patients, 38 underwent TAE due to positive RA results. Clinical data on the TAE patients, such as gender, age, body mass index, TAE interval, hemoglobin (Hb) decrease, operation time, stone size, the number and size of tracts, and clinical bleeding type, were summarized. The types of artery injury in TAE patients and their relationships with clinical characteristics were analyzed.
Retrospective analysis revealed that, among the 38 TAE patients (32 males and 6 females), the mean TAE interval, average Hb decrease, mean tract number, and mean tract size reached 5.00 (6.25) days, 44.50 (24.50) g/L, 1 (0.25), and F20(6), respectively. Among the TAE patients, four kinds of vascular injury were observed, namely, 18 cases of pseudoaneurysm (PA), 12 cases of arteriocaliceal fistula (ACF), 7 cases of arteriovenous fistula (AVF), and 1 case of arterioperirenal fistula (APF). Analysis of the clinical characteristics of the three types of vascular injury (PA, ACF, and AVF) revealed that the number of tracts was the only factor that differed.
The RA results indicate that the types of postoperative renal artery injury mainly include PA, ACF, AVF, and APF, and the number of tracts may be related to the type of vascular injury.
对于经皮肾镜取石术（PCNL）后严重出血，目前尚无关于肾血管损伤的系统分类。
本研究旨在探讨PCNL术后接受经导管血管栓塞术（TAE）的患者的动脉损伤类型及临床特征。
对2009年4月至2023年12月期间因PCNL术后严重出血而行肾动脉造影（RA）的52例患者进行回顾性分析。其中38例因RA结果阳性而接受TAE。总结TAE患者的临床资料，如性别、年龄、体重指数、TAE间隔时间、血红蛋白（Hb）下降情况、手术时间、结石大小、通道数量和大小以及临床出血类型。分析TAE患者的动脉损伤类型及其与临床特征的关系。
回顾性分析显示，在38例TAE患者（32例男性和6例女性）中，TAE平均间隔时间、平均Hb下降值、平均通道数量和平均通道大小分别为5.00（6.25）天、44.50（24.50）g/L、1（0.25）和F20（6）。在TAE患者中，观察到四种血管损伤类型，即18例假性动脉瘤（PA）、12例动脉肾盂瘘（ACF）、7例动静脉瘘（AVF）和1例动脉肾周瘘（APF）。对三种血管损伤类型（PA、ACF和AVF）的临床特征分析显示，通道数量是唯一不同的因素。
RA结果表明，术后肾动脉损伤类型主要包括PA、ACF、AVF和APF，通道数量可能与血管损伤类型有关。
