Radiology, Vol 154, 633-638, Copyright © 1985 by Radiological Society of North America
Percutaneous extraction of urinary calculi: use of the intercostal approach
AT Young, DW Hunter, WR Castaneda-Zuniga, JC Hulbert, P Lange, P Reddy, S Mercado and K Amplatz
The authors achieved successful percutaneous extraction of urinary calculi
via an intercostal approach in 24 patients. In one patient, a large
hydrothorax developed and thoracentesis was required; 2 patients had
moderate and 6 minimal pleural fluid collections which did not require
treatment. No patient had pneumothorax. Intercostal puncture provides
direct access to the upper and middle poles of the kidney when they lie
above the twelfth rib and subcostal angulation is not feasible. Such an
approach is advantageous for stones in the ureter, as well as renal stones
which are inaccessible from the lower pole. Fluoroscopy should be performed
when planning the puncture in order to avoid the lung, and a working sheath
is recommended.
