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1
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Cai J, Ding L, Xie Y, Wang Y. Congenital renal arteriovenous malformation with cirsoid and cavernosal-type characteristics: a case report. J Int Med Res 2021; 49:3000605211016381. [PMID: 34024190 PMCID: PMC8142530 DOI: 10.1177/03000605211016381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Renal arteriovenous malformations (AVMs) are infrequent vascular morphological anomalies. About 20% of AVMs are congenital renal AVMs (CRAVMs). A 53-year-old female patient presented with a 5-day history of gross hematuria and right flank pain. The patient underwent the selective renal arteriography and embolization under local anesthesia. Renal computed tomography angiography (CTA) and digital subtraction angiography (DSA) results showed bleeding of the right renal arteriovenous malformation, both nidus and aneurysm, which indicated that the patient had both cirsoid and cavernosal types of CRAVM. Endovascular management was chosen to treat the patient. The patient was cured and discharged, then followed-up for 3 months. These results show that early identification using radiologic tests is important for diagnosis and treatment of CRAVM.
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Affiliation(s)
- Jieru Cai
- Department of Gastroenterology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; The Institute for Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
| | - Li Ding
- Nursing Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yiwen Xie
- Department of Gastroenterology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; The Institute for Gastroenterology, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuyong Wang
- Department of Urology, Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Yuyong Wang, No. 261, Huansha Road, Department of Urology, Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China. Emails: ;
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2
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Endovascular Interventional Radiology of the Urogenital Tract. ACTA ACUST UNITED AC 2021; 57:medicina57030278. [PMID: 33802895 PMCID: PMC8002831 DOI: 10.3390/medicina57030278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/13/2021] [Accepted: 03/15/2021] [Indexed: 12/26/2022]
Abstract
Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.
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3
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Hongsakul K, Bannangkoon K, Boonsrirat U, Kritpracha B. Transarterial Embolization of a Renal Artery Aneurysm Concomitant With Renal Arteriovenous Fistula. Vasc Endovascular Surg 2017; 52:61-65. [PMID: 29130854 DOI: 10.1177/1538574417736690] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Congenital renal artery aneurysm is uncommon. Moreover, renal artery aneurysm concomitant with a congenital renal arteriovenous fistula is extremely rare. Transarterial embolization is the first-line treatment for these conditions. We report a case of a patient with congenital renal artery aneurysm concomitant with a congenital renal arteriovenous fistula of the upper polar left renal artery which was successfully treated by transarterial embolization with coil, glue, and Amplatzer vascular plug.
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Affiliation(s)
- Keerati Hongsakul
- 1 Division of Interventional Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Kittipitch Bannangkoon
- 1 Division of Interventional Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Ussanee Boonsrirat
- 2 Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Boonprasit Kritpracha
- 3 Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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4
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Nagpal P, Bathla G, Saboo SS, Khandelwal A, Goyal A, Rybicki FJ, Steigner ML. Giant idiopathic renal arteriovenous fistula managed by coils and amplatzer device: Case report and literature review. World J Clin Cases 2016; 4:364-368. [PMID: 27900325 PMCID: PMC5112356 DOI: 10.12998/wjcc.v4.i11.364] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/22/2016] [Accepted: 08/31/2016] [Indexed: 02/05/2023] Open
Abstract
An idiopathic renal arteriovenous (AV) fistula is a rare malformation of the kidney that may present insidiously with heart failure or hematuria. The treatment may be challenging due to large fistula size that may limit endovascular management. The authors report a case of an 85-year-old Caucasian woman who presented with acute heart failure and was found to have a right renal AV fistula. Since she had no prior history of renal intervention or trauma, a diagnosis of idiopathic renal AV fistula was made. She was managed by endoluminal occlusion using multiple stainless steel coils and Amplatzer vascular plug II device. The follow-up computed tomography showed complete occlusion of the fistula. This report highlights the late presentation of this rare disease and presents the utility of the combination of coils and Amplatzer device for management of a large fistula. It also reiterates that even if large, these fistulas can be managed by endovascular occlusion.
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5
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Khawaja AT, McLean GK, Srinivasan V. Successful Intervention for High-Output Cardiac Failure Caused by Massive Renal Arteriovenous Fistula. Angiology 2016; 55:205-8. [PMID: 15026876 DOI: 10.1177/000331970405500213] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Renal arteriovenous fistula is a rare clinical entity that may produce high-output cardiac failure. This report describes the case of an 81-year-old woman in whom recurrent episodes of congestive heart failure developed over a relatively short time. A massive renal arteriovenous fistula was visualized by CT scan and arteriography. Successful embolization was performed under hemodynamic monitoring with complete resolution of the patient’s symptoms.
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Affiliation(s)
- Azimuddin T Khawaja
- Western Pennsylvania Hospital, Temple University School of Medicine, Pittsburgh PA 15224, USA.
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6
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Mizuno A, Morita Y, Fuwa S, Arioka H, Harano Y, Niwa K, Saida Y. Transcatheter Embolization of High-flow Renal Arteriovenous Fistula Using N-butyl Cyanoacrylate Accompanied by Delayed Hydronephrosis. Intern Med 2016; 55:3459-3463. [PMID: 27904109 PMCID: PMC5216143 DOI: 10.2169/internalmedicine.55.7342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Renal arteriovenous fistula (AVF) is an uncommon anomaly characterized by the communication between renal arteries and veins. Renal AVFs are often asymptomatic but are occasionally accompanied by hematuria or heart failure. Transcatheter closure with embolization is a safe and effective treatment for renal AVF. We herein report an 87-year-old patient with heart failure due to renal AVF who was treated by transcatheter embolization. She developed bacteremia with hydronephrosis, which is a rare complication following the embolization of renal AVF.
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Affiliation(s)
- Atsushi Mizuno
- Department of Cardiology, Cardiovascular Center, St. Luke's International Hospital, Japan
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7
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Lopera JE. The Amplatzer Vascular Plug: Review of Evolution and Current Applications. Semin Intervent Radiol 2015; 32:356-69. [PMID: 26622098 DOI: 10.1055/s-0035-1564810] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Amplatzer Vascular Plug (AVP) was created for peripheral embolization as a modification of the family of Amplatz septal occluders used in the treatment of congenital heart malformations. The device has evolved over the years and multiple versions have been launched into the market. Each of the versions of the device has some important modifications in terms of the size of the introducer's system, number of layers, and resultant thrombogenicity. It is very important for the operator to become familiar with the unique features of the AVP, and to understand the advantages and limitations of each model in the AVP family to achieve an optimal embolic result. The purpose of this article is to review the evolution and current clinical applications of the AVP in the field of interventional radiology, with emphasis on the advantages and limitations of this device in comparison with other embolization agents.
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Affiliation(s)
- Jorge E Lopera
- Department of Radiology, UT Health Science Center at San Antonio, San Antonio, Texas
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8
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Woodhams R, Ogasawara G, Ishida K, Fujii K, Yamane T, Nishimaki H, Matsunaga K, Inoue Y. Successful treatment of acquired uterine arterial venous malformation using N-butyl-2-cyanoacrylate under balloon occlusion. Acta Radiol Short Rep 2014; 3:2047981614545910. [PMID: 25346850 PMCID: PMC4207280 DOI: 10.1177/2047981614545910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 07/11/2014] [Indexed: 11/30/2022] Open
Abstract
We present two cases of acquired uterine arterial venous malformation (AVM) which was diagnosed because of massive genital bleeding successfully treated with transcatheter arterial embolization (TAE), using N-butyl-2-cyanoacrylate (NBCA) under balloon occlusion. Balloon occlusion at the uterine artery was performed in both patients for diffuse distribution of NBCA in multiple feeding branches, as well as to the pseudoaneurysm, and for the prevention of NBCA reflux. In one of our patients, balloon occlusion of the draining vein was simultaneously performed to prevent NBCA migration through accompanying high-flow arteriovenous fistula (AVF). Doppler ultrasound at 6 months of both patients documented persistent complete occlusion of AVM. Complete and safe obliteration of acquired uterine AVM was accomplished using NBCA as embolic agent, under balloon occlusion at the communicating vessels of acquired uterine AVM.
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Affiliation(s)
- Reiko Woodhams
- Department of Diagnostic Radiology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Go Ogasawara
- Department of Diagnostic Radiology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kenichiro Ishida
- Department of Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital, Japan
| | - Kaoru Fujii
- Department of Diagnostic Radiology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takuro Yamane
- Department of Diagnostic Radiology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Hiroshi Nishimaki
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Keiji Matsunaga
- Department of Diagnostic Radiology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yusuke Inoue
- Department of Diagnostic Radiology, Kitasato University School of Medicine, Kanagawa, Japan
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Sundarakumar DK, Kroma GM, Smith CM, Lopera JE, Suri R. Embolization of a large high-flow renal arteriovenous fistula using 035″ and 018″ detachable coils. Indian J Radiol Imaging 2013; 23:151-4. [PMID: 24082481 PMCID: PMC3777326 DOI: 10.4103/0971-3026.116574] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Transcatheter embolization of renal arteriovenous fistula (AVF) is a minimally invasive procedure that, in some occasions, can replace surgery and potentially save the kidney. The embolization techniques for the renal AVFs have evolved considerably with the availability of newer hardwares. Still, the risk of inadvertent migration of the embolization materials to the pulmonary circulation is a concern. This article describes a novel technique of coiling the feeding segmental artery to a large high-flow renal AVF using 035″ and 018″ detachable coils only, and briefly reviews the previously described strategies to safely embolize renal AVFs.
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Affiliation(s)
- Dinesh K Sundarakumar
- Department of Radiology, The University of Texas Health Science Center at San Antonio, 7703, Floyd Curl Drive, MC 7800, San Antonio, Texas 78229, USA
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10
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Zhang Z, Yang M, Song L, Tong X, Zou Y. Endovascular treatment of renal artery aneurysms and renal arteriovenous fistulas. J Vasc Surg 2013; 57:765-70. [DOI: 10.1016/j.jvs.2012.09.042] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 07/25/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
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11
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Lorenzen J, Schneider A, Körner K, Regier M, Adam G, Nolte-Ernsting C. Post-biopsy arteriovenous fistula in transplant kidney: Treatment with superselective transcatheter embolisation. Eur J Radiol 2012; 81:e721-6. [PMID: 22417392 DOI: 10.1016/j.ejrad.2012.01.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Revised: 01/15/2012] [Accepted: 01/18/2012] [Indexed: 11/26/2022]
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12
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Transcatheter embolization of a huge renal arteriovenous fistula with Amplatzer Vascular Plug. Heart Vessels 2010; 25:356-8. [PMID: 20676847 DOI: 10.1007/s00380-009-1210-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 09/18/2009] [Indexed: 10/19/2022]
Abstract
A large renal arteriovenous fistula (RAF) may lead to heart failure, renal insufficiency, hematuria, and progressive increase in size of renal vessels. Here we present the case of a 67-year-old man with a huge left RAF, who suffered from exertional dyspnea, nocturnal orthopnea, and impaired renal function. The left renal vein and inferior vena cava were dilated to 4 cm. An Amplatzer Vascular Plug with the largest size of 30 mm in disk diameter was deployed to block the fistula, with balloons inflated at renal artery and vein in advance, to reduce the renal flow in order to prevent plug migration. The decrease of shunt flow after embolization was suboptimal. However, dyspnea ameliorated, which was associated with decreased cardiac murmur, subsided abdominal bruit, normalization of the lowered diastolic pressure, and better renal function. In addition, more microcoils can be applied, using the lodged plug as a framework, to achieve the best clinical improvement.
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13
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Brountzos EN, Ptohis N, Grammenou-Pomoni M, Panagiotou I, Kelekis D, Gouliamos A, Kelekis N. High-flow renal arteriovenous fistula treated with the Amplatzer vascular plug: implementation of an arterial and venous approach. Cardiovasc Intervent Radiol 2008; 32:543-7. [PMID: 18574625 DOI: 10.1007/s00270-008-9383-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Revised: 05/27/2008] [Accepted: 05/28/2008] [Indexed: 10/21/2022]
Abstract
We present a 28-year-old man with a large symptomatic arteriovenous fistula (AVF) treated with embolization using the Amplatzer vascular plug (AVP). Although embolization may be considered the first-line therapy in the treatment of AVFs, there is an inherent high risk of migration of the embolic agents into the venous and pulmonary circulations. This case is illustrative of the ease and safety of using this device in high-flow renal AVFs.
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Affiliation(s)
- Elias N Brountzos
- Second Department of Radiology, Athens University, Medical School, Attikon University Hospital, 1 Rimini St., 12462, Chaidari, Greece.
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Rimon U, Garniek A, Golan G, Schneiderman J, Morag B. Endovascular closure of a large renal arteriovenous fistula. Catheter Cardiovasc Interv 2003; 59:66-70. [PMID: 12720244 DOI: 10.1002/ccd.10500] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A case is described of a large renal arteriovenous fistula causing long-term cardiovascular complications. Successful percutaneous embolization was achieved using temporary occlusion balloons, Guglielmi detachable coils, regular nondetachable spring coils, and cyanacrylate. The advanced therapeutic tools we used can improve the prognosis of patients with large and complicated arteriovenous fistulas and prevent surgery.
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Affiliation(s)
- Uri Rimon
- Department of Diagnostic Radiology, Sackler School of Medicine, Tel-Aviv University, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
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Paschalis-Purtak K, Januszewicz M, Rokicki A, Puciłowska B, Imiela J, Cybulska I, Cieśla W, Prejbisz A, Szostek M, Januszewicz A. Arteriovenous fistula of the kidney: a case report of 47-year-old female patient treated by embolisation. J Hum Hypertens 2003; 17:293-6. [PMID: 12692574 DOI: 10.1038/sj.jhh.1001544] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Arteriovenous fistulas of the kidney are rare. They may be acquired, idiopathic or arise in congenital arteriovenous malformations. There are only few reports in the current literature describing the successful embolisation of idiopathic arteriovenous fistulas. We report a 47-year-old hypertensive female patient with a successfully embolised arteriovenous fistula. Diagnosis was made on the basis of colour duplex Doppler examination and this method enabled further successful embolisation of the fistula.
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Affiliation(s)
- K Paschalis-Purtak
- Department of Hypertension, Institute of Cardiology, Warsaw, Alpejska, Poland.
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