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Immediate and delayed migration of Onyx embolisation into the renal collecting system
  1. Sarah Azari1,
  2. Bohan Liu2,
  3. Shawn Sarin3 and
  4. Thomas Jarrett1
  1. 1Department of Urology, The School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
  2. 2Department of Radiology, The School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
  3. 3Department of Interventional Radiology, The School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
  1. Correspondence to Dr Sarah Azari; saraheazari{at}gmail.com

Abstract

We present a case of Onyx embolisation of a renal pseudoaneurysm following partial nephrectomy with collecting system involvement with subsequent migration of Onyx into the renal collecting system resulting in renal obstruction. This occurred both immediately after embolisation and again 8 years after embolisation. Both cases required ureteroscopic surgical intervention. In the first instance, the pieces were removed using basket extraction. In the second, laser lithotripsy was used in addition to basket extraction. While there are a few cases of embolisation coils eroding into the renal collecting system, this is the second reported case of Onyx migration and the first where ureteroscopy with laser lithotripsy was used. The patient is doing well and undergoing surveillance ultrasounds to ensure there is no further Onyx migration. This may be a consideration for patients with pseudoaneurysm embolisation especially in the setting of prior collecting system damage.

  • Interventional radiology
  • Urology
  • Cancer intervention
  • Urinary and genital tract disorders
  • Urological cancer

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Footnotes

  • Contributors SA and TJ are responsible for the initial conceptualisation. SA wrote the initial draft. BL is responsible for obtaining and interpreting the images. SA, BL, SS and TJ all contributed to the editing process and creation of the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.