Erosion of Embolization Coils into the Renal Collecting System Mimicking Stone

Abstract

Urinary tract interventions can lead to multiple complications in the renal collecting system, including retained foreign bodies from endourologic or percutaneous procedures, such as stents, nephrostomy tubes, and others. We report a case of very delayed erosion of embolization coils migrating into the renal pelvis, acting as a nidus for stone formation, causing mild obstruction and finally leading to gross hematuria roughly 18 years post transarterial embolization. History is significant for a remote unsuccessful endopyelotomy attempt that required an urgent embolization.

Case Series of Angioembolization of Genitourinary System Between 2004 and 2016

“…Patients with complex urologic manifestations are quite a real challenge for working physicians. Indeed, procedures such as pyeloplasty, laser lithotripsy and endopyelotomy are associated with inherent risk of vascular damage (6). In these cases, trans catheter embolization is effective in the treatment of these vascular injuries.…”

Interventional Radiology-Operated Endoscopy: Indications, Implementation, and Innovation

“…Though rare, migrated renal embolization coils have also been retrieved. [14][15][16][17] The removal of migrated coils has a high risk of causing significant bleeding and interventional radiologists may be prepared to treat such complications with simultaneous prone transradial arterial access. 18…”

Erosion of embolization coil into the renal collecting system: Retrograde fragmentation of stone and coil via thulium laser lithotripsy

“… 2 Despite the generally accepted safety profile of embolization coil use, rare instances of coil erosion and subsequent migration into the renal collecting system have been reported, with clinical manifestations emerging anywhere from the acute postoperative period to more than 15 years following the procedure. 4 , 5 Standardized guidelines for managing coil erosion are lacking, with reports detailing various innovative approaches to clinical management. 6 Given the low rates of coil erosion and the absence of standardized treatment pathways, we present a case outlining a novel approach to treating embolization coil erosion with recurrent stone formation after PCNL via retrograde thulium laser coil fragmentation.…”