Value of CT angiography in reducing the risk of hemorrhage associated with mini-percutaneous nephrolithotomy

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Xiang-Jun Meng1,2, Qi-Wu Mi2, Tao Hu3

  • 1Southern Medical University , Guangzhou, Guangdong, P.R. China.

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|September 25, 2015
PubMed

Insights

Computed tomography angiography (CTA) before mini-percutaneous nephrolithotomy (PCNL) may reduce bleeding risks. Patients who had CTA experienced less hemoglobin drop and fewer transfusions, suggesting improved safety for PCNL procedures.

Area of Science:

  • Urology
  • Radiology
  • Nephrology

Background:

  • Mini-percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stones.
  • Hemorrhage is a potential complication of PCNL.
  • Preoperative imaging may help mitigate risks.

Purpose of the Study:

  • To assess the clinical value of computed tomography angiography (CTA) in reducing hemorrhage risk during mini-PCNL.
  • To compare outcomes between patients who underwent CTA and those who had non-contrast CT before mini-PCNL.

Main Methods:

  • Retrospective analysis of 158 patients undergoing mini-PCNL.
  • Group 1 (65 patients) received CTA; Group 2 (93 patients) received non-contrast CT.
  • Recorded clinical characteristics and assessed hemorrhagic complications, including hemoglobin levels and transfusion rates.

Main Results:

  • No significant differences in age, BMI, stone size, operative time, stone-free rate, or hospital stay.
  • Group 2 (non-contrast CT) had a significantly greater hemoglobin drop (3.6 g/dL vs. 2.4 g/dL) and higher transfusion rates (9.7% vs. 1.5%) compared to Group 1 (CTA).
  • One patient in Group 2 developed an arteriovenous fistula requiring embolization.

Conclusions:

  • Preoperative CTA in mini-PCNL is associated with a reduced drop in hemoglobin and fewer transfusions.
  • CTA may be a valuable tool in minimizing bleeding complications during mini-PCNL.
  • These findings suggest CTA can enhance patient safety in PCNL procedures.
Abstract

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