ORLANDO, FL USA (UroToday.com) - Percutaneous renal access can be challenging in complex cases with large stone burden (i.e., staghorn calculi) or a special kidney anatomy. The study group presented a case of an 50-year-old male with a right partial staghorn and proximal ureteric stone, undergoing percutaneous access for PCNL, using the novel Uro Dyna-CT (Siemens Healthcare Solutions, Germany), for high-quality 3-dimensional real-time imaging.
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The patient was referred to radiology for pre-op percutaneous renal access. After two unsuccessful attempts for upper/middle pole NT placement due to plural reflection and overlying lifer a, Uro Dyna-CT was performed. This novel technique correlates real-time fluoroscopic imaging to a simultaneous on-table axial CT scan. By delineating a safe window, right middle-pole access could be gained.
The authors concluded that in select patients, the Uro Dyna-CT adds simultaneous detailed anatomic imaging to fluoroscopic renal access to improve successful puncture, and reduce potential morbidities.
Presented by Shubha De, MD at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
Cleveland Clinic, Cleveland, OH USA
Written by Achim Lusch, MD, University of California (Irvine), and medical writer for UroToday.com