A) PERCUTANEOUS NEPHROSTOMY / ANTEGRADE DJ STENTING
It is done in patients with obstruction to urinary flow from the kidneys. Prolonged obstruction can lead to backflow changes in the kidney and may cause kidney dysfunction. In these cases, the procedure helps to prevent kidney damage.
In this procedure, the kidney is punctured through the skin directly to establish an alternative route for the flow of urine. The treatment is especially recommended when DJ stenting is not possible. It is a highly effective procedure to relieve the obstruction to kidneys. It is a day care procedure and can also be done on an outpatient basis.
B) RENAL ANGIOGRAPHY / EMBOLISATION
Embolisation (blockage) of blood vessels of the kidney can be used as a treatment modality for some kidney tumors. It is also an effective tool to limit the blood loss during kidney surgery.
Bleeding from or into the kidneys can happen especially in cases of surgery or after stone removal. Bleeding from and into the kidneys can be a major source of morbidity and mortality. To prevent any life threatening complication from persistent bleeding refractory to conservative management the mainstay of treatment is surgical removal of the kidney. However, now in a majority of cases the bleeding can be stopped by this procedure and the kidney can be saved.
The procedure involves accessing the renal artery through the groin and injecting particles or coils (springs ) into the vessel to block the blood flow. Bleeding vessel can be closed by embolization techniques, thereby saving the patient from another extensive surgery or in some cases removal of kidney. Embolisation of selective renal vessels can be done for treatment of non- malignant conditions like angiomyolipomas or a pre-operative procedure in nephron sparing surgery.
It is a day care procedure and there is a possibility that the patient can be discharged on the same day.
C) RENAL ANGIOPLASTY/ STENTING
The treatment is recommended when there is a narrowing of the renal artery. Obstruction to flow in the renal artery can cause problem in the renal function or high blood pressure that cannot be controlled by medicines.
The procedure involves accessing the renal artery through a small puncture in the groin. The narrowed or obstructed artery is opened by inflating a balloon in that area (angioplasty). Subsequently, if the narrowed segment fails to remain opened, a “scaffold” (stent) is put in the vessel to keep it open.