Percutaneous Obliteration of Urinary Leakage after Partial Nephrectomy Using N-Butyl-Cyanoacrylate Obliteration of the Urinoma with or without Coil Embolization of the Fistula Tract |
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| Institution: | 1. Department of Radiology, King Fahad Hospital, Jeddah Ministry of Health, Jeddah, Saudi Arabia;2. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 43gil, Seoul, Korea;3. Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 43gil, Seoul, Korea;4. Department of Interventional Therapy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;1. Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 9000 Rockville Pike, Building 10, Room 3N320, Bethesda, MD 20892;2. Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, 9000 Rockville Pike, Building 10, Room 3N320, Bethesda, MD 20892;3. Duke Cancer Institute, Duke University, Durham, North Carolina;4. Division of Diagnostic Imaging and Intervention, Pisa University School of Medicine, Pisa, Italy;1. Department of Radiology, Saiseikai Shiga Hospital, Ohashi 2-4-1, Ritto, Shiga 520-3046, Japan;2. Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan;1. Section of Interventional Radiology, Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, D4-352, Madison, WI 53792;2. School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, D4-352, Madison, WI 53792;3. Department of Medical Physics, University of Wisconsin-Madison, 600 Highland Avenue, D4-352, Madison, WI 53792;4. Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, D4-352, Madison, WI 53792;1. Department of Diagnostic Radiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa Prefecture 259-1193 Japan;2. Department of Cardiovascular Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa Prefecture 259-1193 Japan;1. Division of Biological Sciences, University of California San Diego, La Jolla, California;2. Department of Pathology, School of Medicine, University of California San Diego, La Jolla, California;3. Department of Radiology, University of California San Diego, La Jolla, California;4. Veterans Affairs San Diego Healthcare System, San Diego, California |
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| Abstract: | PurposeTo retrospectively evaluate the safety and efficacy of the percutaneous obliteration of urinary leakage after partial nephrectomy (PN) using coils and N-butyl-cyanoacrylate (NBCA).Materials and MethodsData of 10 consecutive patients who underwent percutaneous obliteration of urinary leakage after PN using coil and NBCA between February 2016 and May 2018 were retrospectively reviewed. A urinary fistulography was performed via the drainage catheter. If the fistulous tract was clearly visualized, super-selective embolization of the fistulous tract with coils and urinoma cavity sealing with NBCA was performed. In cases where the fistulous tract could not be clearly visualized, only urinoma cavity sealing was performed. Outcomes and complications were assessed by reviewing medical records and computed tomography (CT).ResultsIn 7 (70%) patients who showed obvious urinary fistulous tract, coil embolization of the urinary fistulous tract, followed by sealing of the urinoma cavity with NBCA, was performed. Obliteration of the urinoma without coil embolization of the fistula tract was performed in 3 patients (30%) in whom a distinct fistulous tract could not be visualized. The median number of treatment sessions required to achieve clinical success was 1 (range, 1–5). Four patients underwent multiple repeated procedure with successful results. All patients showed gradual decrease in size or complete disappearance of urinoma on follow-up CT without evidence of urinary leakage during the follow-up period (mean, 44.6 weeks; range, 11–117 weeks). There were no procedure-related complications.ConclusionsPercutaneous obliteration of urinary leakage after PN using coils and NBCA is safe and effective. |
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| Keywords: | NBCA"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "$$":[{"#name":"italic" "_":"N"} {"#name":"__text__" "_":"-butyl-cyanoacrylate PN"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "_":"partial nephrectomy |
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