Percutaneous nephrolithotripsy: C-arm CT with 3D virtual navigation in non-dilated renal collecting systems.

PURPOSE We aimed to evaluate the clinical superiority of using C-arm computed tomography (CT) to establish percutaneous nephrolithotripsy (PCNL) access for patients with non-dilated renal collecting systems. METHODS From May 2014 to May 2015, 33 patients underwent C-arm CT-guided puncture to establish PCNL access after failed attempts of ultrasonography-guided nephrostomy. Technical success, procedure details, radiation exposure, complications, and stone-free rate were recorded. RESULTS The technical success rate was 97% (32/33) with a mean puncture score of 4.5/5. Mean puncture, dilation, and fragmentation times were 17.9±6.0, 12.6±3.9, and 33.1±8.8 minutes, respectively. Mean radiation exposure was 4.8±2.1 mSv without serious complications. Stone-free rate was 93.8%. CONCLUSION C-arm CT is a useful tool to establish PCNL access, particularly in cases of upper pole access or complicated anatomy.