Successful Management of Delayed Post-PCNL Renal Pseudoaneurysm Using a Percutaneous Endoscopic Transurethral Resection System: A Case Report

Renal artery pseudoaneurysm is a rare but potentially life-threatening complication following percutaneous nephrolithotomy (PCNL). We report a female who developed massive gross hematuria after an uncomplicated right PCNL. Computed tomography angiography revealed a renal artery pseudoaneurysm, and selective angioembolization failed to achieve definitive hemostasis. As a salvage approach, percutaneous endoscopic intervention was performed. Under direct intrarenal visualization, the actively bleeding arterial branch was identified and successfully coagulated, achieving complete hemostasis. The postoperative course was uneventful with no recurrence of hematuria. This case demonstrates that percutaneous endoscopic coagulation can be an effective alternative for refractory post-PCNL renal pseudoaneurysms.