ARRS 2022 Abstracts


E1137. Achieving Flow State: Interventional Radiology in the Urinary System
  1. Iulian Dragusin; San Antonio Uniformed Services Health Education Consortium
  2. David Reynolds; San Antonio Uniformed Services Health Education Consortium
Conditions requiring interventional radiology management of urologic pathologies are seen in routine clinical, oncologic, and emergency settings. The diagnostic and interventional radiologist must be familiar with these common interventions. Conditions such as ureteral trauma, malignant and congenital obstruction, and fistula formation can be successfully treated with urologic interventions. Indications for intervention are broadly categorized as follows: need of urinary diversion; treating obstruction, removing stones and foreign bodies; purposely obstructing ureteric drainage; and draining infection. The purpose of this educational exhibit is to provide a basic overview of these techniques, their indications, and appearance on multiple modalities such as CT, X-ray, and fluoroscopy.

Educational Goals / Teaching Points
We review interventional urologic techniques and the clinical indications for them as well as after care for patients undergoing these procedures. We provide a multiple modality review of these interventions and the conditions they treat. The various techniques include percutaneous nephrostomy, nephroureteral stents, double J stents, balloon dilation and endopylotomy, lithotripsy and nephrolithotomy, foreign body retrieval, ureteral embolization, and functional studies such as the whitaker test. After reviewing this exhibit the reader will be able to identify the various interventional radiology procedures for the urinary system, the appropriate clinical circumstances they are used for, possible complications to be cognizant of, and the recommended post-intervention care.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Readers will be able to identify a pathologic collecting system and secondary causes of them, such as strictures, stones, infection, and trauma, and the various interventions and equipment used to treat them including stents, coils, drainage catheters, and uroplasty balloons. We also identify possible complications to be aware of such as stent obstruction, nephrolith migration, renal hematoma, vascular injuries, pseudoaneurysm, and bowel perforation.

There are a multitude of diseases and conditions effectively treated by interventional urologic procedures. These are commonly performed procedures in a general interventional radiology practice and commonly encountered by the diagnostic radiologist when evaluating the genitourinary system. Fundamental knowledge of the indications, equipment used, technique, and potential complications of these procedures will improve physician acumen and patient care.