Clinical studyPercutaneous Antegrade Removal of Double J Ureteral Stents via a 9-F Nephrostomy Route
Section snippets
Patients
Between August 1997 and February 2007, 393 6- or 8-F double J stents (Boston Scientific/Microvasive, Boston, Mass; C.R. Bard, Covington, Ga) were placed in an antegrade manner through a nephrostomy tract under fluoroscopic guidance, and 7,860 were placed in a retrograde manner by urologists. All stents were made of polyurethane and had a double pigtail configuration at either end to prevent stent migration. Percutaneous fluoroscopically guided antegrade stent removal of 39 stents in 27 patients
Patients and Access Methods
The causes of ureteral strictures are summarized in Table 1. Ureteral strictures were located in the right ureter in 20 patients, in the left ureter in 18 patients, and in a transplanted ureter in one patient. At stent removal, 25 patients had an 8.5-F nephrostomy tube, and the mean interval between nephrostomy access and stent removal was 48.18 days (range, 2–195 days). Two patients underwent nephrostomy and stent removal during the same session.
Indications for Stent Removal
Double J stents were removed due to stent
Discussion
The retrievability of ureteral stents is very important for their removal in cases of stent blockage or migration (1, 2, 6, 7, 8). Antegrade ureteral stent placement is preferred as the primary route in cases with substantial involvement of the ureteric orifice by the tumor or a tight stricture very close to the ureterovesical junction (4). In this study, we confirmed that percutaneous removal of double J ureteral stents via preexisting nondilated nephrostomy routes was feasible and effective.
References (16)
- et al.
A simplified method of ureteral stent removal using waterless rigid urethroscopy
J Urol
(1997) Retrieval of ureteral stents
Urol Clin North Am
(1982)- et al.
The management of malignant ureteral obstruction treated with ureteral stents
J Urol
(2005) - et al.
Retrograde or antegrade double-pigtail stent placement for malignant ureteric obstruction?
Clin Radiol
(2005) - et al.
Primary antegrade ureteric stenting: prospective experience and cost-effectiveness analysis in 50 ureters
Clin Radiol
(2001) - et al.
Fluoroscopically-guided retrieval of ureteric stents
Clin Radiol
(1995) - et al.
The misplaced double J ureteric stent: technique for repositioning using the nitinol ’gooseneck’ snare
Clin Radiol
(1994) - et al.
Quality improvement guidelines for percutaneous nephrostomy
J Vasc Interv Radiol
(2003)
Cited by (21)
Management of proximal migration of double-J stents after Anderson-Hynes pyeloplasty in children
2021, Journal of Pediatric UrologyCitation Excerpt :In patients with migration of the entire stent into the pelvis, percutaneous antegrade access may be obtained using an access sheath placed under ultrasound or fluoroscopic guidance. The stent is subsequently removed using a snare, basket or forceps [4,8,17]. In children with limited room in the renal pelvis, a 4 F ureteric catheter may be guided into the ureter on a wire after calyceal puncture.
Removal of an intra-renal migrated ureteral stent through a percutaneous nephroscopy in a 2-year-old child
2021, Urology Case ReportsCitation Excerpt :Various methods of retrieval have been described in adults,1–3 but these are technically more challenging in children and infants due to the small anatomical caliber. An antegrade approach through a nephroscopy is an alternative if retrograde retrieval is difficult or impossible.3,4 The patient is a 2-year-old male referred from another center.
Ensnaring the upward migration of double-J stent through nephrostomy route using a wire lasso
2020, Urology Case ReportsClinical Utility of the Modified Snare Technique for Percutaneous Antegrade Removal of Double J Ureteral Stents
2020, Journal of Vascular and Interventional RadiologyCitation Excerpt :Among the devices (including forceps, basket, or snare) used for antegrade DJ stent removal, the snare has been the most commonly used device (2,6–9). Although the overall technical success rate of antegrade DJ stent removal was high, ranging from 95% to 100% in previous studies on removal of 26–39 ureter stents (2,6–9), these success rates are based on the aggregated results for using various devices, including baskets or forceps. The technical success rate for using only snare, so called, simple snare technique, has not been documented in any of these studies and the failed cases with the simple snare technique still certainly exist (8,9).
Urinary Drainage Procedures in Interventional Radiology
2016, Techniques in Vascular and Interventional Radiology
None of the other authors have identified a conflict of interest.