Grubert RM, do Carmo CEF, Morais Neto RS, Tibana TK, Santos RFT, Marchiori E, Nunes TF. Antegrade double-J stenting as an alternative to the retrograde approach: experience of the first 150 cases at a single center in Brazil.
Radiol Bras 2021;
54:353-359. [PMID:
34866694 PMCID:
PMC8630954 DOI:
10.1590/0100-3984.2020.0131]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/31/2020] [Indexed: 11/22/2022] Open
Abstract
Objective
To present our clinical experience with percutaneous antegrade ureteral
stenting.
Materials and Methods
This was a single-center retrospective study in which we reviewed the
electronic medical records of patients who underwent percutaneous
image-guided antegrade ureteral stenting between January 2016 and August
2020. We evaluated 90 patients (48 men). The mean age was 61.4 ± 15
years (range, 30-94 years). Patients were divided into two main groups:
those with malignant neoplasms; and those with non-neoplastic disease.
Technical and clinical success of the procedure were defined, respectively,
as maintenance of the patency of the urinary tract, with a reduction in the
degree of hydronephrosis, and as a reduction in the level of nitrogenous
waste. Postprocedural complications were categorized as major or minor
according to the CIRSE classification.
Results
The study sample comprised 150 antegrade stenting procedures performed in 90
patients, most of whom had previously undergone retrograde stenting that was
unsuccessful. The stenting was bilateral in 60 patients and unilateral in
30. Technical success was achieved in 143 (95.3%) of the procedures, whereas
seven procedures (4.6%) were unsuccessful. Failed procedures were
characterized by inability to place a stent or migration of a stent after
its placement. Complications occurred in 12 (8.0%) of the procedures. Of
those 12 complications, two were classified as major (bleeding) and 10 were
classified as minor (lumbar pain or infection). The most common techniques
used were the over-the-wire technique and the modified technique (in 58.0%
and 42.0% of the cases, respectively). In seven cases (4.7%), a nephrostomy
tube was inserted.
Conclusion
Percutaneous antegrade ureteral stenting is a safe, effective method for the
management of ureteral injuries and obstructions, due to malignant or benign
causes, when the retrograde approach has failed.
Collapse