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Netaji AL, Garg PK, Bhirud DP, Rajagopal R. Balloon-Assisted Endovascular Embolization of High-Flow Renal Arteriovenous Fistula. Indian J Radiol Imaging 2024; 34:790-791. [PMID: 39318558 PMCID: PMC11419743 DOI: 10.1055/s-0044-1786502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024] Open
Affiliation(s)
- Arjun Lokesh Netaji
- Department of Diagnostic & Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pawan Kumar Garg
- Department of Diagnostic & Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Deepak Prakash Bhirud
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Rengarajan Rajagopal
- Department of Diagnostic & Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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2
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Huy NT, Nguyen PT, Tran NTT, Hoa T, Duc NM. Percutaneous intervention for giant renal extrarenal aneurysm and arteriovenous fistula. Radiol Case Rep 2022; 17:4526-4531. [PMID: 36193275 PMCID: PMC9526015 DOI: 10.1016/j.radcr.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/25/2022] Open
Abstract
Arteriovenous fistula is a high-flow vascular malformation characterized by a direct connection between an artery and a vein without the presence of a nidus (a network of arterial and venous channels). Renal artery aneurysm concomitant with a renal arteriovenous fistula (RAVF) is extremely rare. We report the case of a 45-year-old woman with a giant renal artery aneurysm combined with RAVF who presented with gross hematuria. The patient was successfully treated by embolization of a giant extrarenal aneurism and RAVF using coils and a plug device. RAVF can lead to harmful complications, and treatment is necessary upon diagnosis. Endovascular embolization is a feasible, efficient, and safe method able to retain maximal normal renal function
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Affiliation(s)
| | | | - Nguyen-Thi Tuyen Tran
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Tran Hoa
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Corresponding author.
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3
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Duc VT, Duong N, Phong NT, Nam NH, Quoc DA, Cuong T, Huy NH, Duy TL, Chien PC. Large renal arteriovenous fistula treated by embolization: a case report. Radiol Case Rep 2021; 16:2289-2294. [PMID: 34194592 PMCID: PMC8233104 DOI: 10.1016/j.radcr.2021.05.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 11/27/2022] Open
Abstract
Renal arteriovenous fistula (RAVF) is an uncommon vascular malformation of the kidney, which can be congenital, acquired or idiopathic. Although most patients are asymptomatic, RAVF can lead to hypertension, heart failure, renal insufficiency, hematuria, and progressive increase in size of renal vessels. Diagnosis is aided by radiological studies, with digital subtraction angiography as a gold standard. Besides, ultrasound with color Doppler and computed tomography angiography are noninvasive imaging techniques and can be useful for planning the treatment. A large fistula are generally treated by nephrectomy. Intervention can ameliorate the hemodynamic effects of high flow and to preserve the renal parenchymal function. Although endovascular therapy may be challenging due to the large size and high flow of fistula, this report describes a case of huge RAVF was successfully treated by embolization instead of surgery.
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Affiliation(s)
- V T Duc
- Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.,Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
| | - Nqt Duong
- Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.,Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
| | - N T Phong
- Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - N H Nam
- Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - D A Quoc
- Department of Pediatric Heart Surgery, University Medical Centre, Ho Chi Minh City, Vietnam
| | - Ttq Cuong
- Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
| | - N H Huy
- Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
| | - T L Duy
- Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
| | - P C Chien
- Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
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4
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Catelli A, Loiudice G, Corvino A, Castaldo A, Bracale UM, Quarantelli M, Venetucci P. Amplatzer vascular plug IV in the treatment of high flow renal arteriovenous fistula: Case considerations. Radiol Case Rep 2020; 15:1442-1445. [PMID: 32642014 PMCID: PMC7334554 DOI: 10.1016/j.radcr.2020.05.060] [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: 05/19/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 01/22/2023] Open
Abstract
Renal arteriovenous fistula is classified into idiopathic, acquired and congenital. Endovascular therapy has become the gold standard compared to surgery. We present the embolization procedure of a renal fistula postbiopsy in a 57-year-old female patient through the use of St. Jude Medical Amplatzer vascular Plug IV. Although numerous embolizing agents are available, plug type IV has numerous advantages in terms of procedure times, speed of embolization and precision of the occlusion, but with a relative increase in costs.
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Affiliation(s)
- Antonio Catelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Giovanni Loiudice
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", I-80133 Naples, Italy
| | - Anna Castaldo
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | | | - Mario Quarantelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Pietro Venetucci
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
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5
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Shie RF, Su TW, Hsu MY, Chu SY, Ko PJ. Transarterial embolization of a large high-flow right renal arteriovenous fistula using stents and an across-stent wire-trapping technique. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2019; 5:122-127. [PMID: 31193393 PMCID: PMC6529687 DOI: 10.1016/j.jvscit.2018.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 12/10/2018] [Indexed: 11/24/2022]
Abstract
Renal arteriovenous fistulas (AVFs) are rare vascular abnormalities. Their high-flow nature may result in increased cardiac output and lead to heart failure. Transcatheter endovascular management of renal AVFs with various embolization materials has been the treatment of choice in recent years. Embolization of large renal AVFs poses a risk of embolization through the AVF to the pulmonary circulation. Herein, we present the case of a patient whose large high-flow renal AVF was treated by a novel method involving the use of a bare stent and detachable metallic coils—called a wire-trapping technique—as well as compare this method with vascular plugs.
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Affiliation(s)
- Ren-Fu Shie
- Chang Gung University, Taoyuan, Taiwan.,Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ta-Wei Su
- Chang Gung University, Taoyuan, Taiwan.,Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ming-Yi Hsu
- Chang Gung University, Taoyuan, Taiwan.,Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Sung-Yu Chu
- Chang Gung University, Taoyuan, Taiwan.,Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Po-Jen Ko
- Chang Gung University, Taoyuan, Taiwan.,Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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6
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Worth listening to the kidney: An uncommon cause of congestive heart failure. Anatol J Cardiol 2018. [PMID: 29521319 PMCID: PMC5864775 DOI: 10.14744/anatoljcardiol.2018.06982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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7
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Manresa-Manresa F, Sánchez-Rodríguez JM, Nacarino-Mejías V, Peiró de Las Heras J, Ponce-González JF. Aortic Customized Stent-Graft Treatment of Postnephrectomy Renal Pedicle Arteriovenous Fistula. Vasc Endovascular Surg 2017; 51:191-194. [PMID: 28424037 DOI: 10.1177/1538574417698901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A postnephrectomy renal acquired arteriovenous fistula (AVF) is a rare clinical entity that may cause high-output heart failure. Most of the cases are identified time along after surgery. We present a case of a postnephrectomy renal AVF treated with aortic customized stent-graft.
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Affiliation(s)
- Francisco Manresa-Manresa
- 1 Department of Angiology and Vascular Surgery, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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8
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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: 8] [Impact Index Per Article: 1.0] [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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9
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Abdel-Aal AK, Elsabbagh A, Soliman H, Hamed M, Underwood E, Saddekni S. Percutaneous embolization of a postnephrectomy arteriovenous fistula with intervening pseudoaneurysm using the Amplatzer vascular plug 2. Vasc Endovascular Surg 2014; 48:516-21. [PMID: 25487250 DOI: 10.1177/1538574414561230] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although renal arteriovenous fistula (AVF) is an uncommon condition, it may lead to high cardiac output heart failure and renal insufficiency. Recently, percutaneous transcatheter embolization has replaced traditional surgery as the first line of treatment. We report a case of a 68-year-old male who presented with a renal AVF and was treated by percutaneous transcatheter embolization using the Amplatzer Vascular Plug 2 (AVP 2; St Jude Medical, Plymouth, Minnesota) through an arterial access. To our knowledge, the use of AVP 2 device in the treatment of renal AVF as a single embolotherapy device through the transarterial route has not been previously reported in the literature. Our technique demonstrates the feasibility and safety of AVP 2 device in the treatment of renal AVF.
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Affiliation(s)
| | - Ahmed Elsabbagh
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hesham Soliman
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maysoon Hamed
- Department of Family Medicine, University of Alabama, Tuscaloosa, AL, USA
| | - Edgar Underwood
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Souheil Saddekni
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
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10
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Le Huu Nho R, Renard S, Maurin C, Souteyrand P, Le Treut YP. [Giant renal angiomyolipoma with right heart failure]. Prog Urol 2014; 24:479-81. [PMID: 24861690 DOI: 10.1016/j.purol.2014.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 02/05/2014] [Accepted: 02/11/2014] [Indexed: 11/26/2022]
Abstract
We report the case of a 63-year-old woman presenting a 26cm right renal angiomyolipoma with intratumoral arteriovenous fistula responsible for a high-output right heart failure. A radical surgical treatment after preoperative embolization allowed rapid improvement of cardiac symptoms with an uneventful postoperative course.
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Affiliation(s)
- R Le Huu Nho
- Aix Marseille université, 13284 Marseille, France; Service de chirurgie digestive et de transplantation hépatique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - S Renard
- Aix Marseille université, 13284 Marseille, France; Unité de cardiologie, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - C Maurin
- Aix Marseille université, 13284 Marseille, France; Service d'urologie et transplantations rénales, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - P Souteyrand
- Aix Marseille université, 13284 Marseille, France; Service de radiologie, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - Y P Le Treut
- Aix Marseille université, 13284 Marseille, France; Service de chirurgie digestive et de transplantation hépatique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France.
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11
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Sopeña B, Gimena B, Pérez-Rodríguez MT, Rivera A. An unusual cause of pulmonary hypertension and refractory edema. Int J Cardiol 2011; 148:e1-2. [DOI: 10.1016/j.ijcard.2009.01.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Accepted: 01/15/2009] [Indexed: 10/21/2022]
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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: 1.2] [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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Abdel-Gawad EA, Housseini AM, Cherry KJ, Bonatti H, Maged IM, Norton PT, Hagspiel KD. CT Angiography of Renal Arteriovenous Fistulae: A Report of Two Cases. Vasc Endovascular Surg 2009; 43:416-20. [DOI: 10.1177/1538574409340588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Renal arteriovenous fistulas (AVFs) are rare abnormal communications between the arterial and venous circulations that can be congenital or acquired. We describe the multidetector computed tomography angiography (MDCTA) appearance of 2 cases of renal AVF, one with the cirsoid and one with the aneurysmal subtype, and the impact of these findings on therapeutic decision making and treatment follow-up.
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Affiliation(s)
- Ehab A. Abdel-Gawad
- Department of Radiology, El Menia University, El Menia, Egypt, Department of Radiology University of Virginia Health System, Charlottesville, Virginia
| | - Ahmed M. Housseini
- Department of Radiology, Suez Canal University, Ismailia, Egypt, Department of Radiology University of Virginia Health System, Charlottesville, Virginia
| | - Kenneth J. Cherry
- Department of Surgery (KJC, HB), University of Virginia Health System, Charlottesville, Virginia
| | - Hugo Bonatti
- Department of Surgery (KJC, HB), University of Virginia Health System, Charlottesville, Virginia
| | - Ismaeel M. Maged
- Department of Radiology University of Virginia Health System, Charlottesville, Virginia, Department of Radiology, Suez Canal University, Ismailia, Egypt
| | - Patrick T. Norton
- Department of Radiology University of Virginia Health System, Charlottesville, Virginia
| | - Klaus D. Hagspiel
- Department of Radiology University of Virginia Health System, Charlottesville, Virginia,
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14
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A high-flow right-kidney arteriovenous malformation causing right-heart failure. COR ET VASA 2008. [DOI: 10.33678/cor.2008.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Idowu O, Barodawala F, Nemeth A, Trerotola SO. Dual use of an amplatzer device in the transcatheter embolization of a large high-flow renal arteriovenous fistula. J Vasc Interv Radiol 2007; 18:671-6. [PMID: 17494851 DOI: 10.1016/j.jvir.2007.02.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Embolization procedures are now considered the first-line therapy in the treatment of renal arteriovenous fistulas (AVFs). However, a risk posed by the use of these minimally invasive techniques is the migration of occluding agents into the venous and pulmonary circulations. The risk is of particular importance for larger, high-flow fistulas. The authors describe a case in which an Amplatzer Vascular Plug (AVP) was opened upstream of a renal AVF in the dilated feeding artery and used as a filter and a buttress during coil embolization to prevent coil migration during the treatment of the large, high-flow renal AVF. It was then removed and used again as the final embolic device in the renal artery, performing a dual role in the closure of the renal AVF.
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Affiliation(s)
- Oluwatoyin Idowu
- Department of Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St, Philadelphia, PA 19104, USA
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