Background To evaluate the clinical characteristics and angiographic features of transcatheter angiographic embolization (TAE) in patients with active bleeding after percutaneous nephrolithotomy (PCNL).Methods Between October 2009 and April 2018, 45 patients who underwent TAE for hemorrhage control after PCNL were reviewed retrospectively. Patient clinical characteristics and angiographic features of TAE were analyzed.Results Of the 3148 patients, 45 (1.4%), including 35 men (77.78%) and 10

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... n (22.22%), were treated with TAE after PCNL. Ten patients (22.22%) had a history of kidney surgery. The interval from the bleeding episode to TAE was 3 days (range, 1–6 days). In addition, 27 (60.0%) and 18 patients (40.0%) experienced sudden onset of bleeding and delayed bleeding, respectively. Arterial laceration, arteriovenous fistula, and negative angiographic finding was found in 28 (62.2%), 7 (15.6%), and 10 patients (22.2%), respectively. Thirty-five patients (92.1%) achieved primary clinical success. The median corrected hemoglobin decrease from bleeding episode to TAE was 52 g/L (25.25, 71.00). The median corrected hemoglobin decrease rate from bleeding episode to TAE was 13.11 g/L d (5.60, 26.12). The hemoglobin decrease from bleeding episode to TAE was lesser in negative angiographic patients (28.50 (10.75,51.25) g/L VS 53.7 (35.0,73.13) g/L) than in positive angiographic patients (P<0.05).Conclusion TAE is a safe and effective treatment for patients with post-PCNL bleeding. TAE should be performed for post-PCNL bleeding in patients with hemoglobin decrease of >25 g/L or hemoglobin decrease rate of >5.5 g/L·d following conservative management.