Percutaneous Kidney Puncture Using a Novel Contrast-enhanced Ultrasound-guided Technique: First Swine Model In Vivo...

Area of Science:

• Medical Imaging
• Surgical Technology
• Urology

Background:

• Percutaneous nephrolithotomy (PCNL) involves puncturing the renal collecting system.
• Accurate targeting of the nondilated collecting system is crucial for PCNL success and safety.
• Conventional ultrasound guidance has limitations in visualizing critical structures during puncture.

Purpose of the Study:

• To introduce and evaluate a novel dual contrast-enhanced ultrasound (D-CEUS) technique.
• To assess the feasibility and safety of D-CEUS for renal collecting system puncture in a preclinical setting.
• To compare D-CEUS guidance with conventional ultrasound for PCNL.

Main Methods:

• A D-CEUS technique was developed for guiding renal punctures.
• Percutaneous punctures were performed in six swine, with D-CEUS used for the left kidney and conventional ultrasound for the right.
• Outcomes measured included first-attempt success rate, puncture time, and vascular injury incidence.

Main Results:

• D-CEUS showed a significantly higher first-attempt success rate (94.4% vs. 61.1%) compared to conventional ultrasound.
• D-CEUS resulted in a lower incidence of vascular injury (0% vs. 27.8%) and a shorter puncture time (26s vs. 45s).
• The correct puncture rate was also higher with D-CEUS (100% vs. 66.7%).

Conclusions:

• D-CEUS offers real-time visualization of vascular anatomy and needle trajectory, enhancing puncture accuracy.
• This technique has the potential to improve the safety and efficiency of percutaneous nephrolithotomy.
• Clinical validation is necessary to confirm these preclinical findings.