The Synchronous endovascular management of post PCNL concurrent pseudoaneurysm and AV fistula

Abstract

Percutaneous nephrolithotomy is the standard treatment procedure for large stones associated with complications like pseudoaneurysm and arteriovenous fistula with their incidence being < 1%. A post-PCNL case with left flank pain and delayed haematuria presented with macroscopic haematuria and depleting haemoglobin levels. CT angiography with 3-D reconstruction was used for diagnosing and planning of treatment. The patient was successfully treated with super selective angioembolization (SAE) using peripheral coils while preserving the kidney's remaining vascularization. Early diagnosis and active endovascular treatment using angioembolization techniques can be life-saving and resulting in minimal post-procedure complications and early recovery.

Keywords

• AV fistula
• Pseudoaneurysm
• Therapeutic embolization