Mp04-18 Clinical Characteristics of Patients Treated With Dsa After PCNL and Predictive Factors of Dsa Outcomes- A Multicenter 14-Year Retrospective Analysis

You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) I (MP04)1 May 2024MP04-18 CLINICAL CHARACTERISTICS OF PATIENTS TREATED WITH DSA AFTER PCNL AND PREDICTIVE FACTORS OF DSA OUTCOMES- A MULTICENTER 14-YEAR RETROSPECTIVE ANALYSIS Xianghu Meng, Rong Cong, Wei Wang, Yong Guo, Aibing Yao, and Rijin Song Xianghu MengXianghu Meng , Rong CongRong Cong , Wei WangWei Wang , Yong GuoYong Guo , Aibing YaoAibing Yao , and Rijin SongRijin Song View All Author Informationhttps://doi.org/10.1097/01.JU.0001008708.00982.a9.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To investigate the clinical features of DSA patients with severe bleeding after percutaneous nephrolithotomy (PCNL) and the possible predictors of DSA outcomes. METHODS: A retrospective analysis was performed on 3500 PCNL cases of multi-center from April 2009 to February 2023. Among them, 41 cases with severe postoperative bleeding were treated with DSA and embolization was performed in 31 cases, and the other 10 cases with negative DSA continued to be treated by conservative management and with good outcome. Clinical data such as gender, age, BMI, postoperative days to DSA, postoperative decreased Hb, operation time, stone size, preoperative urinary tract infection, preoperative underlying diseases, tract number and tract size of the above patients were analyzed. The timing of DSA intervention for the above patients was summarized, and the possible influencing factors of different DSA results were compared and analyzed. RESULTS: The multi-center retrospective analysis showed that the proportion of DSA after PCNL was about 1.17%, the proportion of embolization was about 0.89%, and the proportion of negative DSA was about 24.4%. The clinical characteristics of 41 DSA patients (38 males and 3 females) showed that: the mean age was (50.83±10.82) y, the mean BMI was (23.92±3.09) kg/m2, and the mean postoperative days to DSA were (5.41±3.77) d. Compared with immediate postoperative Hb, the mean decreased Hb before DSA was (43.45±15.70) g/L. The operative time was (90.49±41.78) min, the average stone size was (41.98±21.51) mm, the preoperative white blood cell count of urine test was 160 (523), creatinine was 77.60 (20.85) umol/L, tract number was 1 (0), tract size was F18 (5). Among the 31 positive DSA patients, 14 cases were pseudoaneurysm (PA), 10 cases were arteriocalyceal fistula, 5 cases were arteriovenous fistula (AVF), 1 case was artery injury extend to the renal capsule, and 1 case was PA combined with AVF. In the comparative analysis of DSA positive and negative patients, there were no statistical differences in gender, age, BMI, postoperative days to DSA, decreased Hb, operation time, stone size, preoperative white blood cell count of urine test, preoperative underlying diseases (hypertension, diabetes, previous surgical history, renal insufficiency), and tract number. However, the tract size of the DSA positive group was larger than that of the DSA negative group (18(6) vs 18(0), p<0.05). CONCLUSIONS: DSA is a good method for diagnosis and treatment of patients with severe bleeding after PCNL. Embolization is an effective way to treat DSA positive patients, and the effective rate can reach 100%. For patients with severe postoperative bleeding, the size of the tract is a possible predictor of DSA positive results. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e42 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Xianghu Meng More articles by this author Rong Cong More articles by this author Wei Wang More articles by this author Yong Guo More articles by this author Aibing Yao More articles by this author Rijin Song More articles by this author Expand All Advertisement PDF downloadLoading ...