Intra-Arterial Embolic Occlusion of a Bleeding Intrarenal Arteriovenous Malformation: A Case Report

Abstract

A 41-year-old female patient with a profusely bleeding intrarenal arteriovenous malformation is described. The bleeding site was localized to the left kidney by cystoscopy and excretory urography. The diagnosis was confirmed by angiography and the malformation was treated by intra-arterial embolization without complications.

Cirsoid renal arteriovenous malformation treated by endovascular embolization with n-butyl 2-cyanoacrylate

“…Several embolic agents have been proposed and applied: autologous clot; gelatin sponge [8]; stainless steel coils and platinum microcoils [9]; alcohol [12]; and NBCA [10]. If the rAVM is supplied by one distinct arterial feeder, occlusion of this feeder with one of these materials will most probably ensure thrombosis of the nidus.…”

“…Lastly, the technique of ablation is a non-selective method because it provokes infarction in 6±48 % of the total renal parenchyma. Alternatively, NBCA diluted in Lipiodol complies well with the criteria of an instantaneous and effective embolic agent to cure rAVMs, provided the glue can be delivered superselectively inside the nidus of the rAVM [9,10]. Similar to the technique of injection in cerebral AVMs, for best results the glue should penetrate into the immediate proximal draining vein to promote occlusion of outflow from other compartments of the rAVM [15].…”

Transarterial embolisation of renal arteriovenous malformation: safety and efficacy in 24 patients with follow-up

“…NBCA diluted in Lipiodol conforms to the criteria of an instantaneous and effective embolic material that can be used to cure renal AVM, provided that NBCA can be delivered super-electively to the nidus. 11,20 As seen in the present study, NBCA can be useful for obliterating the nidus or multiple fine feeding vessels in patients with a high-flow shunt; however, there is a risk of pulmonary embolism when shunt control is incomplete or the concentration of NBCA is inadequate at the time of the NBCA injection.…”

Management of renal arteriovenous malformations: A pictorial review

“…Approximately 200 cases have been reported to date [2, 11–15]. RAVMs and CRAVMs used to be classified as variceal and as cavernous malformations, respectively [4, 7, 9, 10]. However, since the introduction of the Mulliken and Glowacki classification for vascular malformations and the criteria set by the International Society for Study of Vascular Anomalies, these terms have been abandoned [10, 16].…”