在恶性尿路梗阻患者中，评估荧光导引下串联输尿管支架的放置和交换的安全性和功效，以管理植入单个双J支架失败。同时，我们还旨在研究是否可以使用TUS延长通常接受的DJS更换周期。此回顾性研究涉及11名患者（10名女性），年龄范围为27-64岁，中位数为49岁，他们因不到3个月的植入单个DJS失败而接受TUS（同侧两个8F DJS）放置。最初的TUS交换间隔为6个月，并将其延长到9个和12个月，适用于7名患者。从TUS放置到经皮肾造口，重复交换或死亡的时间间隔定义为支架通畅持续时间。11名患者中的14个输尿管在中位随访时间为45天（范围为35-60天）期间发生了植入单个DJS失败。TUS的技术成功率为100％，并成功地进行放置和交换，没有早期重大并发症。共进行了39次程序（11次放置和28次交换程序），涉及55个输尿管。与单个DJS支架[45天（范围为35-60天）]相比，尿路通畅中位时间与TUS显着增加[300天（范围为60-440天）]（P <0.001）。荧光导引下TUS的放置和交换可以安全有效地进行。使用TUS可以减少频繁更换DJS支架的需要并延长通畅持续时间。

To evaluate the safety and efficacy of the placement and exchange of tandem ureteral stents (TUS) under fluoroscopic guidance in the management of indwelling single double-J stent (DJS) failure in patients with malignant ureteral obstruction. We also aimed to investigate whether the generally accepted exchange period of DJSs could be extended using TUS.This retrospective study involved 11 patients (10 female) with an age range of 27-64 years, median of 49 years, who underwent TUS (ipsilateral two 8F DJSs) placement due to indwelling single DJS failure occurring in less than 3 months. TUS exchanges were performed initially at 6-month intervals, and subsequent exchange intervals were extended to 9 and 12 months for seven patients. The interval from initial TUS placement to percutaneous nephrostomy, repeat exchange, or death was defined as the duration of stent patency.Indwelling single DJS failure occurred during a median follow-up of 45 days (range, 35-60 days) in 14 ureters of 11 patients. TUS were successfully placed and exchanged with a technical success rate of 100% without any early major complications. Thirty-nine procedures (11 placement and 28 exchange procedures) in 55 ureters were performed. The median duration of urinary patency was significantly higher with TUS [300 days (range, 60-440 days)] compared with single DJSs [45 days (range, 35-60 days)] (P < 0.001).The placement and exchange of TUS can be safely and effectively performed under fluoroscopic guidance. The need for frequent DJS exchange could be reduced with increased duration of stent patency using TUS.