Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Percutaneous transrenal ureteral plug embolization: is there a need for tissue adhesives?

1.

Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany

2.

Department of Urology and Paediatric Urology, University Hospital Würzburg, Würzburg, Germany

Diagn Interv Radiol 2020; 1: -
Read: 193 Published: 17 November 2020

PURPOSE: To evaluate the feasibility, effectiveness and safety of ureteral embolization exclusively using Amplatzer Vascular Plugs (AVPs) in the management of ureteral leakages.

METHODS: A retrospective analysis of seven patients with ureteral leakages and fistulas having undergone transrenal ureteral embolization with AVPs was performed. In all cases AVPs were deployed via a preexisting percutaneous transrenal nephrostomy tube. Technical and clinical success as well as complications were evaluated.

RESULTS: During a 4-year study period, eleven ureters in seven patients were embolized using AVPs. In one case additional coil embolisation was conducted. Technical success in terms of sufficient occlusion of the treated ureter was achieved in 100 % of the procedures. Median size of used plugs was 16.0 mm (range 12 - 18 mm). Number of deployed AVPs ranged between one and three. Median procedural time was 24.00 minutes, and a median dose area product of 58.92 Gy*cm2 was documented. No procedure-related complications occurred. During a median follow-up period of 7.0 weeks, recurrence of the treated leak could not be observed.

CONCLUSION: Ureteric plug embolization in patients with ureteral leakages or fistulas is a feasible, effective and safe technique, even without a combination of tissue adhesives. However, due to the often-limited prognosis and life expectancy of the affected patients, long-term experiences are still lacking.

EISSN 1305-3612