Percutaneous Residual Stone Removal Post-lithotripsy During a Routine Nephrostogram: A Case Report and Interventional Implications

Author(s): Matthew Montanarella, Shannon Beardsley MD

Shock wave lithotripsy with percutaneous nephrolithotomy is an important treatment option for urolithiasis. Although this technique frequently removes the entirety of the stone, residual fragments of the stone may be unknowingly left within the urinary tract. When residual stones are visualized during post-procedure nephrostogram, interventional radiology can retrieve them percutaneously using the original access used by the surgeon for lithotripsy as is demonstrated in this case. Using a standard stone retrieval basket, or in this case report the basket component of an Arrow-Trerotola™ PTD® Percutaneous Thrombolytic Device, residual stones fragments of various sizes can be removed at the same session. If successful, the attendant risks and expense of additional urologic procedures to remove residual stones are avoided, thus demonstrating a potentially important role for interventional radiologists in the clinical management of these patients.