HIGH FREQUENCY ROTABLATION AS A NEW THERAPEUTIC PROCEDURE FOR OBSTRUCTED METALLIC URETER STENTS

Treatment of ureteral strictures caused by invasive growth of malignant processes or fibrotic changes after irradiation is challenging. Surgical urinary diversion is often complicated in patients with progressive malignancies or after irradiation of the abdomen. At the same time recurrent infection, dislocation and encrustation are common problems after application of percutaneous nephrostomy or Double J (Medical Engineering Corp., New York, New York) stents, which results in the need for frequent exchange. Implantation of metallic wall stents is an attractive therapeutic option. However, until now only limited data have been available on obstruction rates and on adequate treatment of obstruction in conjunction with such stents. We report on a patient with bilateral obstruction due to encrustation of bilaterally implanted titanium wall stents. The obstructions were successfully treated with a high frequency rotational atherectomy device designed and exclusively used in cardiology for treating atheromatous coronary stenosis. CASE REPORT