Retrograde Approach Research Articles

Impact of body mass index on acute outcome in percutaneous coronary intervention of chronic total occlusion

BackgroundPercutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. There is only insignificant knowledge reported in the literature about the influence of body mass index (BMI) on acute outcome, including success rates and complications in CTO-PCI. MethodsBetween 2012 and 2017, we included 508 patients. They underwent PCI for at least one CTO. Antegrade and retrograde CTO techniques were applied. The retrograde approach was used only after failed antegrade intervention. BMI was calculated according to the definitions of the World Health Organization. It was subdivided as normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), obese (30–34.9 kg/m2), and very obese (≥35 kg/m2). The Shapiro–Wilk test was used to test for normality of distribution. Continuous variables were tested for differences with Kruskal–Wallis or Mann–Whitney U test as appropriate. Categorical variables were tested with Fisher exact test. ResultsOut of the 508 patients, 77 (15.2%) had normal weight, 286 (56.3%) were overweight, 106 (20.9%) obese, and 39 (7.7%) very obese. Radiation dose and examination time increased with elevated BMI categories (p < 0.001, p = 0.026). Success rates were similar in all BMI categories (p = 0.645). In-hospital procedural complications were rare and showed no statistically significant difference (p = 0.185). ConclusionsOur retrospective study suggests that there exists no significant association between overweight and acute outcome in patients undergoing CTO-PCI. It is safe and feasible to perform.

Retrograde vs. antegrade fl exible nephroscopy for detection of residual fragments following PNL: A prospective study with computerized tomography control.

ABSTRACTIntroduction:The main aim of stone surgery is to establish stone free status. Performing flexible nephroscopy is an effective tool in this manner. The aim of this study was to evaluate the role of retrograde flexible nephroscopy for detection of residual fragments following percutaneous nephrolithotomy (PNL) in comparison with antegrade approach.Materials and Methods:Data of 137 patients underwent ECIRS was collected prospectively. In all cases following stone clearance, collecting system was checked for residual fragments. First antegrade than retrograde flexible nephroscopy was performed and success rates to reach all calices and detection of residual fragments were noted. All patients underwent CT and success rate of antegrade and retrograde approaches were compared. PPV and NPV of retrograde approach to detect residual fragments were calculated.Results:Antegrade and retrograde nephroscopy successfully accessed all of the calices in 101 (73.7%) and 130 (94.9%) patients respectively (p<0.0001). Residual fragments were observed in 18 (13.1%) patients following antegrade flexible nephroscopy. Retrograde approach identified residual stones in 17 more cases. These cases were treated with flexible nephroscopy or secondary percutaneous tract. Postoperative CT revealed residual stones in 10 (7.3%) patients. PPV and NPV of retrograde flexible nephroscopy were 83.3% and 96.2%.Conclusions:Flexible nephroscopy effectively detects residual fragments following PNL. Retrograde approach was more successful than antegrade approach to reach all calices. We recommend performing retrograde flexible nephroscopy following PNL especially in complex cases as it has the potential to increase SFR, decrease the need for second look surgery and unnecessary postoperative imaging.

Balloon dilation for failed pyeloplasty in children?

ABSTRACTObjective:Pyeloplasty is considered the gold standard treatment for ureteropelvic junction obstruction (UPJO). However, the failure rate of pyeloplasty is as high as 10% and repeat pyeloplasty is more difficult. This study aimed to evaluate the efficacy of balloon dilatation for failed pyeloplasty in children.Materials and Methods:Between 2011 and 2017, 15 patients, aged 6 months to 14 years, were treated with balloon dilation for restenosis of UPJO after a failed pyeloplasty. Ultrasound and intravenous urography were used to evaluate the primary outcome. Success was defined as the relief of symptoms and improvement of hydronephrosis, which was identified by ultrasound at the last follow-up.Results:All patients successfully completed the operation, 13 patients by retrograde approach and 2 patients by antegrade approach. Thirteen patients were followed for a median of 15 (4 to 57) months and 2 patients were lost to follow-up. Resolution of the hydronephrosis was observed in 5 cases. The anteroposterior diameter (APD) of the pelvis decreased by an average of 12.4 ± 14.4mm. Eight patients needed another surgery. The average postoperative hospital stay was 1.78 ± 1.4 days. Two patients experienced fever after balloon dilation. No other complications were found.Conclusions:Balloon dilatation surgery is safe for children, but it is not recommended for failed pyeloplasty in that group of patients, owing to the low success rate.

Tu1050 ANTEGRADE VERSUS RETROGRADE SINGLE BALLOON ENTEROSCOPY- IS THERE A DIFFERENCE IN PERFORMANCE?

Single balloon enteroscopy (SBE) is a widely used method of examining the portion of small bowel where conventional upper endoscopy and colonoscopy fail to reach. There are 2 major approaches of single balloon enteroscopy- through mouth or ante-grade approach (AG) or through anus or retrograde (RG)approach. Aim of this study was to assess the differences in performance and complications of both these approaches.

PC072. Innominate Artery Revascularization: Long-term Outcomes and Comparison of Open and Endovascular Approach

Atherosclerotic disease of the innominate artery (IA) is rare and can lead to cerebral and upper extremity ischemia symptoms. Nonocclusive lesions can be treated with endovascular interventions, often with a hybrid approach while performing a right carotid endarterectomy (RCEA). Occlusive lesions usually require treatment through a median sternotomy and bypass. The purpose of our study was to review the short- and long-term outcomes of IA revascularization in our institution. Our section’s operative database was used to identify patients who underwent IA revascularization between January 1998 and December 2018. Patients who underwent IA stenting (IAS), combined RCEA and IAS, and aorta-innominate bypass (AIB) were collected. Our primary end points were freedom from neurologic event, all-cause mortality, and need for reintervention. Thirty-three patients (18 female [55%]) who underwent IA revascularization were identified. Average age was 67 ± 8 years, and mean clinical follow-up was 51 ± 21 months. Most patients (30 [91%]) were taking a statin and antiplatelet therapy. Twenty-one patients (64%) were symptomatic. Twelve patients (36%) were asymptomatic and underwent combined RCEA with retrograde IAS for critical right carotid stenosis and IA stenosis. Preoperative imaging included carotid duplex ultrasound and computed tomography angiography. Eighteen patients (55%) underwent RCEA and IAS, 11 patients (33%) underwent IAS in a retrograde approach through right carotid exposure, and 4 patients (12%) underwent AIB. Patients who underwent AIB had chronic IA occlusions with failed endovascular interventions. All patients were followed up with carotid duplex ultrasound intraoperatively and at 1-month and 6-month intervals after the procedure. Perioperative stroke rate of 3% involved one patient who developed reperfusion syndrome after RCEA and IAS. Perioperative mortality was 0%. Long-term stroke rate was 0%, and long-term mortality was 15% (5/33) due to cardiac disease (Fig 1). Overall restenosis rate was 9% involving three patients who required secondary interventions for IA in-stent restenosis (Fig 2). IA interventions through a hybrid or open approach are safe with acceptable perioperative stroke and mortality rates. Long-term durability of these interventions seems acceptable. Patients undergoing IAS appear to have a higher rate of restenosis compared with AIB; therefore, close follow-up with noninvasive imaging is recommended.Fig 2Innominate artery (IA) interventions. IAS, Innominate artery stenting; R CEA, right carotid endarterectomy.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review.

Background Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported. Materials and Methods Seven patients with dysphagia and refractory PLS underwent serial endoscopic dilation therapy during a 4.5-year period. Dilation characteristics, technical success, clinical success, and diet advancement (as assessed by Diet/GT scale) were measured. Results. All strictures were complex, and there were no reported complications. The median number of dilations per patient was 12 (range 7 to 48). The average interval in between dilations was six weeks. Technical success was achieved in 6/7 patients, and clinical success was achieved in 2/7 patients. 6/7 patients had advancements in Diet/GT scores. Conclusions Dilation of refractory PLS is safe and effective and frequently requires the use of a retrograde approach, fluoroscopic guidance, and/or lumen patency strings. Serial dilations are required to maintain luminal patency, relieve dysphagia, and advance oral diet. The definition of clinical success of dilation in these patients should avoid the use of a specific time interval between dilations to characterize success.

Acute and Midterm Outcomes of Antegrade vs Retrograde Crossing Strategies for Endovascular Treatment of Iliac Artery Chronic Total Occlusions

Purpose: To examine whether an antegrade or retrograde crossing strategy for treatment of iliac artery chronic total occlusions (CTOs) is associated with differences in procedural or midterm outcomes. Materials and Methods: A dual-center retrospective cohort study was conducted in 168 patients (mean age 66.4±10.6 years; 116 men) treated for CTOs in 110 common iliac arteries (CIA), 52 external iliac arteries (EIA), and 26 combined CIA/EIAs. Logistic regression models were developed to determine the association between crossing strategy and procedural complications, 1- and 3-year target lesion revascularization (TLR), and major adverse limb events (MALE). Results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: An initial antegrade strategy was more common for EIA CTOs (p<0.005), and an initial retrograde strategy was more often used in CIA (p<0.005) and combined CIA/EIA (p<0.005) CTOs. Crossover to an alternate approach was required in 27.6% of initial antegrade attempts and 9.6% of initial retrograde attempts. EIA CTOs were the most likely lesions to be treated successfully with the initial attempt (either strategy). In all, 123 (65.4%) lesions were successfully crossed with a final retrograde approach and 65 with a final antegrade approach. Overall target lesion success was high for both groups (95.1% vs 93.2%, p=0.456). Lesions treated with a final retrograde approach were shorter (75.3±34.9 vs 87.6±31.3 mm, p=0.005) and were more likely to be treated with a reentry device (34.2% vs 9.2%, p<0.001) and with balloon-expandable stents (39.2% vs 17.7%, p=0.005). The final antegrade approach was associated with a lower risk of target lesion complications (OR 0.07, 95% CI 0.01 to 0.81, p=0.034). The two crossing approaches were associated with similar estimates of 1- and 3-year TLR and MALE. Conclusion: A final antegrade approach was associated with lower rates for complications but the 2 approaches were similar in terms of lesion success, TLR, and MALE. The EIA CTOs were more likely to be treated with an antegrade approach and more likely to be crossed successfully with the initial approach irrespective of the crossing direction.

Percutaneous retrograde approach and perioral placement of a covered esophageal stent in a patient with a complex esophageal cancer

Percutaneous retrograde approach and perioral placement of a covered esophageal stent in a patient with a complex esophageal cancer

Predictors of Failure of Retrograde Approach for Percutaneous Intervention of Coronary Chronic Total Occlusion: A Single-Center Experience

Objective: The aim of the study is to assess the predictors of failure of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) lesions using a retrograde approach. Methods: The present study retrospectively enrolled all 211 patients who underwent retrograde CTO PCI from January 2009 to December 2015 at Shanghai Institute of Cardiovascular Disease. Multivariate Cox regression analysis was used to assess potential predictors of retrograde CTO PCI failure including sex, vascular access site, sheath size, prior PCI, prior coronary artery bypass grafting, history of myocardial infarction, target vessel of CTO, J-CTO score, retrograde wire crossing collaterals, and reverse controlled antegrade and retrograde subintimal tracking (CART) use. Results: Of the 211 patients studied, retrograde CTO PCI was successful in 115 (54.5%) patients, and in an additional 46 (21.8%) with an antegrade approach after retrograde failure. For the 50 (23.7%) patients who failed both retrograde and antegrade approaches, the most common (50% [25/50]) reason was inability to cross collaterals with the retrograde wire. This group of patients had fewer instances of a prior PCI (P

Role of Retrograde Transpopliteal Angioplasty for Superficial Femoral Artery Occlusion

Background: surgical interventions are indicated for patients with peripheral arterial disease (PAD) who developed CLI or debilitating IC that is refractory to conservative management; while bypass, with an autologous vein or prosthetic conduit, is the mainstay of open surgical management of PAD. On the other hand, the percutaneous endovascular interventions has emerged as an alternative effective, and safe, treatment option in patients with PAD. Objective: the aim of the study was to evaluate the effectiveness and safety of the retrograde popliteal approach for recanalization of long segment occlusion of superficial femoral artery in cases with chronic lower limb ischemia. Patients and Methods: this is a prospective study conducted on 30 patients presenting to Al-Azhar University Hospitals and Mataria Teaching Hospital; all of them have chronic lower limb ischemia due to proximal long segment occlusion of superficial femoral artery (SFA) after failure to pass through the antegrade access either by the ipsilateral or by the contralateral femoral approach. Results: ankle brachial index (ABI) is a commonly used surrogate marker of atherosclerosis. In the present study, the rate of complications was relatively low (16.7%) in which pseudoaneurysms were encountered in 10% and arteriovenous fistulae were encountered in 6.7% of the patients. Conclusion: retrograde popliteal approach is feasible, safe, and effective technique for the management of CTO of superficial femoral artery in patients with failure of pass through the antegrade access either by the ipsilateral or by the contralateral femoral approach.

TCTAP C-149 Multivessel Coronary Artery Disease with Aberrant RCA CTO Lesion by Retrograde Approach

### Patient Initials or Identifier Number 0617925 ### Relevant Clinical History and Physical Exam A 66 old male admitted to our hospital for congestive heart failure. He had a medical history of IHD, mid LAD was implanted Cypher stent. His coronary risk factors were diabetes, hypertension, and

Revascularization of right coronary artery chronic total occlusion by bilateral knuckle technique.

The retrograde and hybrid approach have improved the overall success rate of the recanalization of chronic total occlusion (CTO) lesions.

Oclusão percutânea de aneurisma roto do seio de Valsalva para dentro do ventrículo direito

ABSTRACT The authors report on two patients whose congenital sinus of Valsalva aneurysms had ruptured into the right ventricle and were successfully occluded percutaneously. Three different devices were implanted using two different approaches. Percutaneous closure warranted that one patent ductus arteriosus occluder through a transvenous antegrade approach and that one coil plus one ventricular septal defect occluder were implanted through an arterial retrograde approach. The procedures were accomplished without complications, the devices were well positioned at angiography and echocardiography views [...]

The Retrograde Approach As an Alternative for Failed Antegrade Access for Difficult Below the Knee Chronic Total Occlusions

The Retrograde Approach As an Alternative for Failed Antegrade Access for Difficult Below the Knee Chronic Total Occlusions

Urodynamic analysis of extraperitoneal Studer orthotropic ileal neobladder following radical cystectomy

Objective To evaluate changes of the urodynamics of extraperitoneal Studer orthotropic ileal neobladder after radical cystectomy. Methods Between July 2013 and October 2017, Retrospective analysis was performed on 58 bladder cancer patients.58 patients who underwent retrograde extraperitoneal approach of radical cystectomy and Studer orthotopic ileal neobladder. The patients were comprised of 56 male and 2 female patients with average age of 62 years. There were 9 cases of T1, 26 cases of T2, 20 cases of T3, and 3 cases of T4.All operations were completed by open suprapubic extraperitoneal approach, then entered the abdominal cavity. An ileal segment 50-55 cm long was isolated which was 25 cm proximal to the ileocecum. The 35-40 cm ileal segment was detubularized along its antimesenteric border. The anterior wall was folded forward with U-shaped and the edges were sutured to formed a neobladder. The proximal 15cm was reserved for the double isoperistaltic afferent limb. The lowest part of the neobladder was anastomosed with urethral stump, the peritoneum was closed at the mesentery, and the neobladder was completely placed extraperitoneal. Upper urinary tract function was examined by renal function test, enhanced CT, IVU or cystography. Uroflowmetry, urodynamic evaluation, diurnal and nocturnal continence were performed at 3, 6, 12, 24 months following the surgery. Results After removed of the catheter, all patients were able to urinate through the urethra. The 3, 6, 12, 24 month follow-up data of urodynamic were compared. The maximum neobladder capacity was[(378±66) vs.(381±102)vs.(438±75)vs.(472±96)]ml, the maximum flow rate[(10.2±2.8)vs. (14.9±4.3) vs.(16.4±3.6)vs.(17.6±2.1)]ml/s, maximum bladder pressure during filling was[(23.0±4.6)vs. (21.7±7.1)vs.(20.6±6.4)vs.(18.8±6.3)]cmH2O, the PVR was[(68.0±33.2)vs.(36.2±10.1)vs.(30.6±11.9)vs.(14.0±9.6)]ml . There were significant differences between the 6-month and 12-month.There were no significant differences in the maximum bladder pressure during flowing[(38.6±7.4)vs.(49.2±6.8)vs.(58.4±10.5)vs.(56.8±7.4)]cmH2O. 53 cases were followed up 12 months after surgery. Excellent daytime and nighttime continence was 98%(52/53)and 83%(44/53)in the first year. Mild unilateral hydronephrosis occurred in 2 cases 1 month after surgery. Blood electrolytes and renal function were within the normal range. 1 case presented bilateral mild hydronephrosis 12 months after surgery, without bladder and ureter regurgitation. The blood electrolyte and renal function of the other patients were in normal range with no signs of ureteral stricture and upper urinary tract hydronephrosis. Conclusions Extraperitoneal Studer orthotopic ileal neobladder reduced the interference of postoperative intraperitoneal intestinal tract on neobladder function. Postoperative patients have a smooth urination, a safe pressure during the storage period. The urination period, and the function of day and night urinary control is close to normal physiological characteristics. Key words: Urinary bladder neoplasms; Extraperitoneal approach; Orthotropic ileal neobladder; Urodynamic analysis

Sacral neuromodulation treating chronic pelvic pain: a meta-analysis and systematic review of the literature.

Sacral neuromodulation (SNM) is gaining popularity as a treatment option for chronic pelvic pain (CPP). Our hypothesis is that SNM is effective in improving CPP. A systematic search was conducted through September 2018. Peer-reviewed studies using pre- and postpain intensity scores were selected. The primary outcome was pain improvement on a 10-point visual analog scale (VAS) (adjusted or de novo) in patients with CPP. Secondary outcomes included comparing SNM approaches and etiologies and evaluating lower urinary tract symptoms (LUTS). Fourteen of 2175 studies, evaluating 210 patients, were eligible for further analysis. The overall VAS pain score improvement was significant [weighted mean difference (WMD) -4.34, 95% confidence interval (CI) = -5.22, to-3.64, p < 0.0001)]. Regarding SNM approach, both standard and caudal approaches had significant reduction in pain scores: WMD -4.32, CI 95% = -5.32, to -3.31 (p < 0.001) for the standard approach, compared with WMD -4.63, 95% CI = -6.57 to -2.69 (P < 0.001), for the caudal approach (p = 0.75). While significant improvement in pain was observed both in patients with and without interstitial cystitis/bladder pain syndrome (IC/BPS), the observed improvement was lower in patients with (WMD -4.13, CI 95% -5.36 to -2.90 versus without (WMD -5.72, CI 95% = -6.18, to-5.27) IC/BPS (p = 0.02). SNM was effective in treating voiding symptoms (frequency, urgency, nocturia) associated with IC/BPS (all p < 0.01). SNM is an effective therapy for CPP in both IC/BSP and non-IC/BSP patients, with better results in non-IC/BSP patients. Outcomes of the antegrade caudal approach were comparable with the standard retrograde approach.

Iatrogenic aortic regurgitation after radiofrequency ablation of idiopathic ventricular arrhythmias originating from the aortic valvular region

Radiofrequency ablation at the aortic root has the potential risk of aortic regurgitation (AR). This study investigated the incidence and clinical features of iatrogenic AR after catheter ablation of idiopathic ventricular arrhythmias originating from the aortic root. We studied 45 consecutive patients with idiopathic ventricular arrhythmias originating from the aortic cusps (ACs; AC group; n = 32 [71%]) and papillary muscles (control group; n = 13 [29%]) who underwent ablation via a retrograde aortic approach and serial echocardiography before and within 24 hours after the ablation procedure. No patients had preexisting AR. After ablation, mild AR occurred in 5 AC group patients and 1 control group patient. Regurgitant flow was observed at the center of the aortic leaflets in 3 patients, the left coronary cusp-noncoronary cusp commissure in 2 patients, and both in 1 patient. No patients undergoing ablation only above the aortic valve developed AR. In AC group patients, the occurrence of AR was associated with a longer ablation time (24 ± 14 minutes vs 10 ± 5 minutes; P < .01) and higher average output (36.6 ± 4.2 W vs 32.0 ± 3.2 W; P = .01). The same severity of AR still existed after 16.2 ± 3.6 months of follow-up. No patients required any additional medical management or surgical intervention. Iatrogenic mild AR after ablation in the aortic root occurred with a noticeable prevalence, which was associated with extensive ablation both above and below the ACs as well as catheter-related mechanical factors. Although it did not appear to aggravate the hemodynamic status during the mid-term follow-up, careful monitoring of AR progression should be considered.

Recanalization of Chronic Total Occlusions Using Modern Endovascular Techniques

to assess results of percutaneous coronary intervention (PCI) with contemporary endovascular techniques of recanalization of chronic total coronary artery occlusions (CTO) in patients with ischemic heart disease (IHD). Occlusion (CTO) he procedural and in-hospital outcomes of consecutive patients undergoing chronic total occlusion percutaneous coronary intervention. We retrospectively analyzed data from 456 consecutive patients (mean age 59.9±7.1 years, 18.2 % women) who underwent CTO PCI procedures (n=477) during 2014-2016 in the E. N. Meshalkin National Medical Research Center. CTO was localized in the right (61.2 %), left anterior descending (23.2 %) and left circumflex (15.3 %) coronary arteries. In one patient CTO was located in the left main coronary artery. According to the J-CTO score, 30 % of lesions were classified as easy, 36.4 % intermediate, 23.7 % difficult, and 18.9 % very difficult. Technical and procedural successes were achieved in 374 (78.4 %) and 366 patients (76.7 %), respectively. Antegrade approach was used in 378 (79.2 %), retrograde approach - in 99 (20.7 %) cases. Retrograde approach as primary strategy was used in 27 cases (5.7 %). Most frequent access for CTO PCI was radial artery, contralateral injection was used in 151 cases (31.6 %). Total number of stents per lesion was 1.6±0.98. The mean fluoroscopy time was 36.2±31 min. The rate of procedural adverse events in our study was low and similar to the non-CTO PCI series. However, despite the large number of CTO PCIs, the procedural success rate was still lower than in centers with dedicated programs for the management of such patients. Thus, further work is required to overcome this difference. Possible solution of this problem might be development and introduction in clinical practice of an algorithm for CTO recanalization.

Efficacy and safety of percutaneous transcatheter aortic valvuloplasty prior to non-cardiac surgery in Japanese patients with severe aortic stenosis

This study aimed to investigate the efficacy of percutaneous transcatheter aortic valvuloplasty (PTAV) performed prior to non-cardiac surgery and the safety of non-cardiac surgery after PTAV in elderly Japanese patients. Between March 2012 and August 2018, 14 patients who underwent PTAVs prior to non-cardiac surgery were enrolled. The mean age was 82.2 ± 7.0 years. A total of 9 patients (64.3%) were women. A retrograde approach was selected for 57.1% of the patients. More than 75% of the procedures were performed using echocardiographic imaging. Echocardiographic data including the aortic valve area (AVA), peak aortic valve blood velocity flow (AVF), peak aortic valve pressure gradient (AVPG), and mean AVPG significantly improved after PTAV (AVA; from 0.54 ± 0.11 to 0.80 ± 0.13 cm2, peak AVF; from 4.6 ± 0.8 to 3.8 ± 0.7 m/s, peak AVG; from 87.9 ± 28.0 to 62.2 ± 19.9 mmHg, mean AVG; from 49.8 ± 18.9 to 35.7 ± 11.6 mmHg; p < 0.001, p < 0.001, p < 0.001, p = 0.0012, respectively). Neither complications related to the PTAV procedure nor procedural mortality were noted. Non-cardiac surgery after PTAV was safely performed; there were no significant adverse events during non-cardiac surgery and no in-hospital mortality occurred after non-cardiac surgery. PTAV prior to non-cardiac surgery in elderly Japanese patients with severe aortic stenosis is safe and effective. In addition, non-cardiac surgery after PTAV can be safety performed without adverse events.

Percutaneous antegrade ureteral stent placement: single center experience.

We aimed to present our clinical experience with percutaneous antegrade ureteral stent placement in a single center. Electronic records of patients who underwent percutaneous image-guided ureteral stent placement between September 2005 and April 2017 were reviewed. A total of 461 patients (322 males, 139 females; age range, 19-94 years; mean age, 61.4±15 years) were included in the study. Patients were classified into two main groups: those with neoplastic disease and those with non-neoplastic disease. Failure was defined as persistence of high level of serum creatinine or an inability to place stents percutaneously. Postprocedural complications were grouped as percutaneous nephrostomy and stent placement related complications. A total of 727 procedures in 461 patients were included in the study: 654 procedures (90%) in 407 patients (88.3%) were in the neoplastic group and 73 procedures (10%) in 54 patients (11.7%) were in the non-neoplastic group. Our technical success rates were 97.7% and 100% and complication rates were 3.1% and 4.1% in neoplastic and non-neoplastic groups, respectively. Seven stents retrievals and 112 balloon dilatations were performed successfully. Percutaneous antegrade ureteral stent placement is a safe and effective method for management of ureteral injuries and obstructions due to both malignant and benign causes when the retrograde approach has failed.