Transrenal Ureteral Embolization Utilizing Amplatzer Vascular Plugs and N-Butyl Cyanoacrylate Glue.

This retrospective study presents three consecutive patients who underwent bilateral ureteral occlusion using the Amplatzer vascular plugs and N-butyl cyanoacrylate glue sandwich method. The patients were 63- and 65-year-old males and a 79-year-old female. Indications for the procedure included severe cystitis and complex vesicular fistulas unresponsive to urinary diversion.

Skin-to-tumor Distance Predicts Treatment Failure of T1A Renal Cell Carcinoma Following Percutaneous Cryoablation.

Objective: To determine the impact of skin-to-tumor (STT) distance on the risk for treatment failure following percutaneous cryoablation (PCA).

Methods: We retrospectively reviewed patients who underwent PCA with documented T1a recurrent renal cell carcinoma (RCC) at 2 academic centers between 2005 and 2015. Patient demographics, tumor characteristics, and perioperative and postoperative course variables were collected.

Comparison of Multiparametric MRI Scoring Systems and the Impact on Cancer Detection in Patients Undergoing MR US Fusion Guided Prostate Biopsies.

Introduction: Multiple scoring systems have been proposed for prostate MRI reporting. We sought to review the clinical impact of the new Prostate Imaging Reporting and Data System v2 (PI-RADS) and compare those results to our proposed Simplified Qualitative System (SQS) score with respect to detection of prostate cancers and clinically significant prostate cancers.

Methods: All patients who underwent multiparametric prostate MRI (mpMRI) had their images interpreted using PI-RADS v1 and SQS score.

Interventional radiologic techniques for screening, diagnosis and treatment of patients with renal artery stenosis.

Renal artery stenosis resulting in renovascular hypertension or renal ischemia is a potentially treatable condition that results in increased morbidity and mortality, especially among older individuals. Sophisticated imaging techniques are used for screening and identification of affected patients to guide therapy. Treatment guidelines recommend intervention in patients with significant renal artery stenosis, although recent evidence has questioned the benefit of intervention in certain populations.

Improving detection of clinically significant prostate cancer: magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy.

Purpose: Given the limitations of prostate specific antigen and standard biopsies for detecting prostate cancer, we evaluated the cancer detection rate and external validity of a magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy system used at the National Institutes of Health.

Materials And Methods: We performed a phase III trial of a magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy system with participants enrolled between 2012 and 2013. A total of 153 men consented to the study and underwent 3 Tesla multiparametric magnetic resonance imaging with an endorectal coil for clinical suspicion of prostate cancer.

Urology resident experience with an elective in interventional radiology: a pilot evaluation.

Purpose: The objective of the study was to evaluate the initial experience with an elective in interventional uroradiology.

Methods: Seven urology residents completed a minimum 2-month elective in interventional radiology (IR). A survey was administered before and immediately after the elective.

Angiographic findings of primary versus salvage varicoceles treated with selective gonadal vein embolization: an explanation for surgical treatment failure.

Background And Purpose: Gonadal vein angioembolization is a successful means of primary and salvage treatment for symptomatic varicoceles. We aim to investigate angiographic findings during embolization of primary varicoceles vs those with failed surgical ligation.

Patients And Methods: Between 1992 and 2010, 106 cases referred to our interventional radiologists for primary or salvage varicocelectomy were reviewed.

Management of hemorrhagic complications associated with percutaneous nephrolithotomy.

Urologists have witnessed replacement of complex open surgical procedures with minimally invasive therapies over the past quarter century. Nothing personifies this more than an anatrophic nephrolithotomy in the management of kidney stones. The Boyce procedure, once the gold standard for staghorn calculi, is rarely performed.

Percutaneous cholecystolithotomy: a case for fulguration of the gallbladder wall.

Percutaneous cholecystolithotomy (PC) has been described previously as an alternative to laparoscopic cholecystectomy in high-risk patients and in those with adherent gallbladders that are not amenable for laparoscopic cholecystectomy. However, it is associated with a high (41%) recurrence of cholelithiasis due to intact gallbladder mucosa. In this paper, we describe a case of PC with fulguration of the gallbladder mucosa to scar and defunctionalize the mucosa and thus prevent recurrence of stones.

Totally bloodless percutaneous renal surgery.

Introduction: We evaluated the feasibility of intraoperative transarterial balloon occlusion of renal artery as a novel technique to reduce blood loss in high-risk patients undergoing complex percutaneous renal surgery (PRS).

Methods: Four patients (staghorn calculi: n=2, renal pelvis TCC: n=1, ureteropelvic junction obstruction: n=1) underwent transfemoral arteriography prior to PRS. The renal artery was identified and an occluding balloon was inflated in the main renal artery.

First Prize (tie): Hemorrhage following percutaneous renal surgery: characterization of angiographic findings.

Purpose: Percutaneous surgery is an established approach to a spectrum of renal pathology, and hemorrhage is the most concerning complication of this technique. We determined the frequency of postoperative hemorrhage requiring selective angioembolization (sae), the efficacy of this approach, and characterized the angiographic findings.

Methods: We reviewed our database of 4695 patients who underwent percutaneous renal surgery and identified patients requiring SAE for postoperative hemorrhage.

Selective arterial prostatic embolization (SAPE) for refractory hematuria of prostatic origin.

Objectives: To assess SAPE as an alternative treatment option in patients with refractory hematuria of prostatic origin.

Methods: A retrospective analysis of charts from 10 patients. Two patients were excluded from the analysis because of severe atherosclerotic disease that prevented selective angiography of the pelvic vasculature.

Persistent prostatic hematuria.

Prostatic hematuria can be a challenging clinical problem. In this Review we discuss the spectrum of methods for diagnosing prostatic hematuria and the pharmacologic and minimally invasive therapies currently available to treat primary disease and refractory cases. Before making a diagnosis and starting therapy, however, other, nonprostatic sources of hematuria must be ruled out.

Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms.

Prompt diagnosis of rupture and impending rupture of abdominal aortic aneurysms is imperative. The computed tomographic (CT) findings of ruptured abdominal aortic aneurysms are often straightforward. Most ruptures are manifested as a retroperitoneal hematoma accompanied by an abdominal aortic aneurysm.