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Occult renal artery pseudoaneurysm causing persistent hematuria after flexible Thulium fibered laser lithotripsy: A case report and literature review of rare but potentially fatal complication

Renal artery pseudoaneurysm may develop after laser flexible ureteroscopy stone lithotripsy (FURSL). Typical symptoms include flank pain, persistent hematuria, delayed refractory anemia, or hemorrhagic shock in case of pseudoaneurysm rupture. This complication of laser FURSL is very rare with only f...

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Autores principales: Al Barajraji, Moncef, Coscarella, Mathieu, Holz, Serge, Moussa, Ilan, Naudin, Michel, Brassart, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10400803/
https://www.ncbi.nlm.nih.gov/pubmed/37547792
http://dx.doi.org/10.1016/j.radcr.2023.07.030
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author Al Barajraji, Moncef
Coscarella, Mathieu
Holz, Serge
Moussa, Ilan
Naudin, Michel
Brassart, Nicolas
author_facet Al Barajraji, Moncef
Coscarella, Mathieu
Holz, Serge
Moussa, Ilan
Naudin, Michel
Brassart, Nicolas
author_sort Al Barajraji, Moncef
collection PubMed
description Renal artery pseudoaneurysm may develop after laser flexible ureteroscopy stone lithotripsy (FURSL). Typical symptoms include flank pain, persistent hematuria, delayed refractory anemia, or hemorrhagic shock in case of pseudoaneurysm rupture. This complication of laser FURSL is very rare with only five cases reported in the literature as of April 2023, of which one involved Thulium laser. We report the case of a 65-year-old man with recurrent renal lithiasis who underwent FURSL using Thulium fibered laser (TFL) for 8 mm stone of left kidney upper pole. Persistent hematuria developed postoperatively, secondary to a pseudoaneurysm from a segmental branch of the left renal artery. It was diagnosed on arteriography performed for sudden hemorrhagic shock 27 days after surgery. Selective embolization with metallic micro-coils resolved hematuria. Although laser FURSL is often uncomplicated and TFL is regarded as safe, this complication should be suspected when refractory hematuria or hemodynamic instability follows the procedure. We report this case to add support to the current literature and outline procedural risk factors and useful precautions during the procedure.
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spelling pubmed-104008032023-08-05 Occult renal artery pseudoaneurysm causing persistent hematuria after flexible Thulium fibered laser lithotripsy: A case report and literature review of rare but potentially fatal complication Al Barajraji, Moncef Coscarella, Mathieu Holz, Serge Moussa, Ilan Naudin, Michel Brassart, Nicolas Radiol Case Rep Case Report Renal artery pseudoaneurysm may develop after laser flexible ureteroscopy stone lithotripsy (FURSL). Typical symptoms include flank pain, persistent hematuria, delayed refractory anemia, or hemorrhagic shock in case of pseudoaneurysm rupture. This complication of laser FURSL is very rare with only five cases reported in the literature as of April 2023, of which one involved Thulium laser. We report the case of a 65-year-old man with recurrent renal lithiasis who underwent FURSL using Thulium fibered laser (TFL) for 8 mm stone of left kidney upper pole. Persistent hematuria developed postoperatively, secondary to a pseudoaneurysm from a segmental branch of the left renal artery. It was diagnosed on arteriography performed for sudden hemorrhagic shock 27 days after surgery. Selective embolization with metallic micro-coils resolved hematuria. Although laser FURSL is often uncomplicated and TFL is regarded as safe, this complication should be suspected when refractory hematuria or hemodynamic instability follows the procedure. We report this case to add support to the current literature and outline procedural risk factors and useful precautions during the procedure. Elsevier 2023-07-28 /pmc/articles/PMC10400803/ /pubmed/37547792 http://dx.doi.org/10.1016/j.radcr.2023.07.030 Text en © 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Al Barajraji, Moncef
Coscarella, Mathieu
Holz, Serge
Moussa, Ilan
Naudin, Michel
Brassart, Nicolas
Occult renal artery pseudoaneurysm causing persistent hematuria after flexible Thulium fibered laser lithotripsy: A case report and literature review of rare but potentially fatal complication
title Occult renal artery pseudoaneurysm causing persistent hematuria after flexible Thulium fibered laser lithotripsy: A case report and literature review of rare but potentially fatal complication
title_full Occult renal artery pseudoaneurysm causing persistent hematuria after flexible Thulium fibered laser lithotripsy: A case report and literature review of rare but potentially fatal complication
title_fullStr Occult renal artery pseudoaneurysm causing persistent hematuria after flexible Thulium fibered laser lithotripsy: A case report and literature review of rare but potentially fatal complication
title_full_unstemmed Occult renal artery pseudoaneurysm causing persistent hematuria after flexible Thulium fibered laser lithotripsy: A case report and literature review of rare but potentially fatal complication
title_short Occult renal artery pseudoaneurysm causing persistent hematuria after flexible Thulium fibered laser lithotripsy: A case report and literature review of rare but potentially fatal complication
title_sort occult renal artery pseudoaneurysm causing persistent hematuria after flexible thulium fibered laser lithotripsy: a case report and literature review of rare but potentially fatal complication
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10400803/
https://www.ncbi.nlm.nih.gov/pubmed/37547792
http://dx.doi.org/10.1016/j.radcr.2023.07.030
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