Renal allograft arteriovenous fistula and large pseudoaneurysm

Abstract

The patient was a 51-year-old female. Post-biopsy arteriovenous fistula (AVF) and pseudoaneurysm in a renal allograft were diagnosed 5 yr and 4 months after she received a renal transplantation. Four years after the diagnosis, interventional treatment for the AVF and pseudoaneurysm was performed because of a high risk of pseudoaneurysm rupture. Although the longitudinal diameter of the pseudoaneurysm was more than 5 cm, this AVF and pseudoaneurysm were treated successfully by a percutaneous transluminal embolization, and renal function has remained stable after embolization. A selective interventional procedure proved effective for the large pseudoaneurysm in the renal allograft. Therefore, when a transcutaneous needle biopsy of the renal allograft is performed, although there are no apparent symptoms or signs of vascular complications during the clinical course, periodical examinations such as echo-Doppler imaging should be made on the allograft.

Renal Mass Core Biopsy: Accuracy and Impact on Clinical Management

“…Pseudoaneurysm formation is a recognized complication of biopsy [26,27], although the incidence is unknown because most are probably asymptomatic. We identified no other long-term complications-specifically, no tumor seeding.…”

Color Doppler findings of post-biopsy arteriovenous fistula in renal transplant

“…Only a small percentage of these fistulas are sufficiently large in size to warrant surgical intervention for closure 34. Few cases are associated with pseudoaneurysms, which if small in size, resolve simultaneously with the fistula 2.…”

Interventional Radiologic Management of Renal Transplant Dysfunction: Indications, Limitations, and Technical Considerations

“…Because of the end-arterial supply of the kidney, a proximal occlusion is adequate to exclude AVFs or pseudoaneurysms from the circulation (Fig 13) (27). In AVFs with high blood flow, temporary balloon occlusion of the draining vein may be necessary during coil embolization to prevent coils from making their way into the systemic circulation (28). Pseudoaneurysms with a narrow neck may be embolized with coils tightly packed within the sac itself ( Fig 14).…”