Aneurisma cirsoide renal: una rara causa de hematuria severa

Abstract

Renal congenital arteriovenous fistulas represent a diagnostic dilemma. They may present asymptomatic or condition clinical features derived from the shunt and high cardiac output (hypertensive cardiopathy and congestive heart failure) or from the erosion and acute hemorrhage into the urinary tract (severe renal hematuria). Treatment should be conservative with embolization or supraselective sclerosis. Nevertheless, in cases of big fistulas, post embolization revascularization, or hemodynamic instability nephrectomy is an excellent option.

Idiopathic renal arteriovenous fistula, a rare cause of severe hematuria: Case report

“…Renal arteriography is the key to diagnosis, being the conservative treatment of choice by means of selective arterial embolization, it allows complete resolutions without significant renal parenchymal damage. 2 , 5 Most reports include follow-up of patients during a year, in which no recurrences have been observed. Conventional surgery such as partial nephrectomy is performed when conservative treatment fails.…”

“…Despite the high success rate of embolization, only 40% have a cure, 28% partially remit; complications have been reported in 52% of cases, such as: renal loss, tissue necrosis, venous thrombosis, pulmonary embolism, tachycardia, fever and recanalization. 1 , 2 …”

“…It is classified according to its cellular characteristics (hemangiomas or vascular malformations), according to vascular flow (high or low flow), according to arterial, venous, arteriovenous, lymphatic or combined predominance and according to its clinical behavior. 1 , 2 Renal arteriovenous fistulas can be of congenital origin (22–25%), idiopathic (3–5%) or acquired (70–75%). 2 , 3 High-flow vascular malformations (congenital) are called cirsoid aneurysms when they acquire a nest disposition.…”

“… 1 , 2 Renal arteriovenous fistulas can be of congenital origin (22–25%), idiopathic (3–5%) or acquired (70–75%). 2 , 3 High-flow vascular malformations (congenital) are called cirsoid aneurysms when they acquire a nest disposition. 2 Acquired aneurysms are more frequent and may be secondary to renal traumas, tumors or iatrogenic causes such as: renal biopsy, percutaneous renal surgery, percutaneous nephrostomy, open surgery and extracorporeal shock wave lithotripsy.…”