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A review of radiologically guided percutaneous nephrostomies in 303 patients
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Purpose:
To determine the morbidity and mortality associated with radiologically guided percutaneous nephrostomy (PCN) and to identify possible contributory risk factors.
Materials And Methods:
The authors retrospectively reviewed 454 consecutive PCNs in 303 patients performed during a 4-year period. PCNs performed specifically for nephrolithotomy were excluded. Self-retention loop catheters (8-12 F) were placed with use of a modified Seldinger technique in all patients. Preprocedural antibiotics were administered routinely. Demographic variables, technical factors related to tube placement, and risk factors were examined with respect to tube malfunction and 30-day morbidity and mortality.
Results:
Technical success was 99%. The overall complication rate was 6.5%, including hemorrhage requiring transfusion after 13 PCNs (2.8%). A baseline platelet count of less than 100,000/mm3 was a significant risk factor for hemorrhage requiring blood transfusion. The 30-day mortality rate was 3.1%; however, none of these deaths were procedure related.
Conclusion:
Radiologically guided PCN with self-retention catheters is associated with a high technical success rate and low morbidity.