Percutaneous nephrostomy: placement under CT and fluoroscopy guidance.

OBJECTIVE The purpose of this paper is to present our experience with CT- and fluoroscopy-guided percutaneous nephrostomy tube (PNT) placement and to describe the technique of placement with patients in the supine-oblique position. MATERIALS AND METHODS A CT scanner was coupled with a ceiling-mounted C-arm for fluoroscopy at the CT table, PNT was done with CT localization and fluoroscopic control. We attempted 148 placements in 129 patients, with most patients in the supine or the supine-oblique position. RESULTS Successful PNT placement was achieved in 144 (97%) of 148 kidneys. In the native kidney group, 101 (81%) of 124 PNTs were placed with the patients in the supine-oblique position. We experienced no major complications, three (2%) minor complications, and two (1%) catheter dislodgments. CONCLUSION CT-fluoroscopy control allows routine PNT placement with patients in the supine or the supine-oblique position and is associated with the lowest complication rate to our knowledge.

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