Percutaneous nephrostomy: comparison of sonographic and fluoroscopic guidance

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Abstract
Both sonography and fluoroscopy have been recommended for renal localization and needle guidance for percutaneous nephrostomy. The respective efficacies of both methods have been compared in a prospective study of 88 patients undergoing percutaneous nephrostomy by the catheter over guide wire technique. Fifty-five patients had initial puncture using either an A-mode (42 patients) or real time (13 patients) sonographic aspiration transducer, while 33 patients had a single plane vertical beam fluoroscopy for puncture guidance. The use of either sonographic method for the initial needle puncture significantly reduced the number of puncture attempts (p = 0.000004) and potential iatrogenic risk, eliminated the need for intravenous administration of contrast material, allowed initial safe introduction of a large caliber needle, and decreased the length of time needed to perform the procedure.

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