Utility of POPVESL scoring system in the management of renal pseudoaneurysm: a retrospective study

Abstract

Abstract Background We intended to assess the role of POPVESL scoring system in managing renal pseudoaneurysm at our institute which is a referral center in this region. Methods We retrospectively reviewed the records of all patients who were managed for renal pseudoaneurysm between January 2020 and December 2022. Data were collected from patient medical records and analyzed by using SPSS Statistics for Windows version 29.0. Data were expressed as mean ± standard deviation (SD) or median for continuous variables, whereas frequency and percentage were used to express qualitative data. Demographic data, type of procedure, operative data, post-procedure data of patients, management type, i.e., conservative or angioembolization were recorded and POPVESL score of individual patients was calculated. Data analysis was conducted among subgroups based on management type, i.e., conservative vs angioembolization. ROC curves were utilized to find the threshold value for predicting the need of angioembolization. Results Out of 55, pseudoaneurysm develops after USG guided PCN in 4 individuals, i.e., 7.3%; renal biopsy in 11, i.e., 20% and PCNL in 40, i.e., 72.7%. On statistical analysis, hemoglobin drop, number of PCV transfused, size of vascular lesion and interval of readmission showed significant differences among subgroups and were predictive of the need for angioembolization. There was a significant difference in POPVESL score between both subgroups. POPVESL score 11 and above is 100% specific and 90% sensitive for angioembolization. Conclusion Renal pseudoaneurysm with a low POPVESL (i.e., < 11) score can be managed conservatively. This scoring system has the potential to help in making bedside decision for managing intrarenal vascular bleeding.

Keywords

• Pseudoaneurysm
• Angioembolization
• Conservative management
• POPVESL score
• Percutaneous nephrolithotomy