Interventional Radiology - Original Article

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

10.5152/dir.2021.20640

  • Anne Marie Augustin
  • Lukas Koneval
  • Charis Kalogirou
  • Arkadius Kocot
  • Ralph Kickuth

Received Date: 27.08.2020 Accepted Date: 16.11.2020 Diagn Interv Radiol 2021;27(6):762-767

PURPOSE:

We aimed 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 7 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, 11 ureters in 7 patients were embolized using AVPs. In one case additional coil embolization 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 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 the addition of tissue adhesives. However, due to the often limited prognosis and life expectancy of the affected patients, long-term experiences are still lacking.