Percutaneous nephrolithotomy during uninterrupted aspirin therapy in high-cardiovascular risk patients

Preliminary report

David A. Leavitt, Nithin Theckumparampil, Daniel M. Moreira, Sammy E. Elsamra, Bradley Andrew Morganstern, David M. Hoenig, Arthur D. Smith, Zeph Okeke

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective To determine the feasibility and safety of performing percutaneous nephrolithotomy (PCNL) in high-cardiovascular risk patients remaining on aspirin therapy.

Methods We retrospectively reviewed all PCNLs performed by 3 fellowship-trained endourologists at a single institution between July 2012 and January 2014. All patients remaining on aspirin for imperative indications through the day of surgery were evaluated for surgical outcomes and thromboembolic events.

Results Of 281 PCNL procedures performed during the study period, 16 (5.7%) were performed in 14 patients taking aspirin, uninterrupted, through surgery. Mean surgery time was 66 minutes, mean estimated blood loss was 161 mL, and mean length of hospital stay was 2.8 days. All patients were stone free. There were no intraoperative complications. A total of 5 patients experienced a postoperative complication (n = 4, Clavien grade II; n = 1, Clavien grade IIIa). No patient experienced a perioperative thromboembolic or cardiac event. Three patients required a blood transfusion postoperatively, and none experienced delayed renal bleeding.

Conclusion PCNL can be performed safely and effectively in high-cardiovascular risk patients continuing aspirin perioperatively. Compared with the potential sequelae of a thromboembolic or cardiac event, PCNL is associated with an acceptably low transfusion rate, and should be considered a viable treatment option for large renal stones in this population.

Original languageEnglish (US)
Pages (from-to)1034-1038
Number of pages5
JournalUrology
Volume84
Issue number5
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Percutaneous Nephrostomy
Aspirin
Therapeutics
Length of Stay
Kidney
Intraoperative Complications
Ambulatory Surgical Procedures
Blood Transfusion
Hemorrhage
Safety

ASJC Scopus subject areas

  • Urology

Cite this

Percutaneous nephrolithotomy during uninterrupted aspirin therapy in high-cardiovascular risk patients : Preliminary report. / Leavitt, David A.; Theckumparampil, Nithin; Moreira, Daniel M.; Elsamra, Sammy E.; Morganstern, Bradley Andrew; Hoenig, David M.; Smith, Arthur D.; Okeke, Zeph.

In: Urology, Vol. 84, No. 5, 01.01.2014, p. 1034-1038.

Research output: Contribution to journalArticle

Leavitt, DA, Theckumparampil, N, Moreira, DM, Elsamra, SE, Morganstern, BA, Hoenig, DM, Smith, AD & Okeke, Z 2014, 'Percutaneous nephrolithotomy during uninterrupted aspirin therapy in high-cardiovascular risk patients: Preliminary report', Urology, vol. 84, no. 5, pp. 1034-1038. https://doi.org/10.1016/j.urology.2014.06.076
Leavitt, David A. ; Theckumparampil, Nithin ; Moreira, Daniel M. ; Elsamra, Sammy E. ; Morganstern, Bradley Andrew ; Hoenig, David M. ; Smith, Arthur D. ; Okeke, Zeph. / Percutaneous nephrolithotomy during uninterrupted aspirin therapy in high-cardiovascular risk patients : Preliminary report. In: Urology. 2014 ; Vol. 84, No. 5. pp. 1034-1038.
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