Retrograde Intrarenal Surgery for Nephrolithiasis with Partially Migrated Renal Artery Embolisation Coil: A Case Report

Abstract

Transcatheter renal artery embolisation is an effective and minimally invasive treatment option for acute renal bleeding. However, it is associated with a variety of complications, which can be classified as early or late according to the time of presentation. Coil migration leading to renal calculi formation is a late complication of transcatheter or percutaneous renal arterial embolisation. A 47-year-old diabetic male patient presented with a recurrent right renal staghorn calculus. Four years ago, the patient underwent a right Percutaneous Nephrolithotomy (PCNL). Following the procedure, he had to undergo a renal arterial embolisation for postoperative haemorrhage. The patient this time did not consent for repeat PCNL, therefore a staged right Retrograde Intrarenal Surgery (RIRS) was performed. Complete clearance of stone and extraction of the migrated coil was achieved in a three-staged procedure. Embolisation coils in the proximity of the pelvi-calyceal system, can migrate into the system, and form a nidus for stone formation. These stones and the migrated coil can be managed effectively and safely with RIRS.

Keywords

• calculus
• coil-migration
• nephrolithotomy
• renal bleeding