Ruptured renal arteriovenous malformation successfully treated by catheter embolization: a case report

Takeuchi, Nobuhiro; Nomura, Yusuke

doi:10.1186/1756-0500-7-19

Cited by 12 publications

(8 citation statements)

References 6 publications

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“…fistulas create a high venous return and an increase in cardiac output, resulting in high-output heart failure. Perirenal hemorrhage from renal AV shunts has rarely been reported, but may prove fatal(18).…”

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confidence: 99%

Renal Arteriovenous Shunts: Clinical Features, Imaging Appearance, and Transcatheter Embolization Based on Angioarchitecture

Maruno¹,

Kiyosue

Tanoue³

et al. 2016

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Renal arteriovenous (AV) shunt, a rare pathologic condition, is divided into two categories, traumatic and nontraumatic, and can cause massive hematuria, retroperitoneal hemorrhage, pain, and high-output heart failure. Although transcatheter embolization is a less-invasive and effective treatment option, it has a potential risk of complications, including renal infarction and pulmonary embolism, and a potential risk of recanalization. The successful embolization of renal AV shunt requires a complete occlusion of the shunted vessel while preventing the migration of embolic materials and preserving normal renal arterial branches, which depends on the selection of adequate techniques and embolic materials for individual cases, based on the etiology and imaging angioarchitecture of the renal AV shunts. A classification of AV malformations in the extremities and body trunk could precisely correspond with the angioarchitecture of the nontraumatic renal AV shunts. The selection of techniques and choice of adequate embolic materials such as coils, vascular plugs, and liquid materials are determined on the basis of cause (eg, traumatic vs nontraumatic), the classification, and some other aspects of the angioarchitecture of renal AV shunts, including the flow and size of the fistulas, multiplicity of the feeders, and endovascular accessibility to the target lesions. Computed tomographic angiography and selective digital subtraction angiography can provide precise information about the angioarchitecture of renal AV shunts before treatment. Color Doppler ultrasonography and time-resolved three-dimensional contrast-enhanced magnetic resonance angiography represent useful tools for screening and follow-up examinations of renal AV shunts after embolization. In this article, the classifications, imaging features, and an endovascular treatment strategy based on the angioarchitecture of renal AV shunts are described.

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confidence: 99%

Renal Arteriovenous Shunts: Clinical Features, Imaging Appearance, and Transcatheter Embolization Based on Angioarchitecture

Maruno¹,

Kiyosue

Tanoue³

et al. 2016

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“…5 The etiology of idiopathic RAVF cannot be expounded exactly, and it is hypothesized that it develops when preexisting renal aneurysms form shunts with adjacent renal segmental veins in almost all cases of RAVF. 6 In our patient, the RAVF concomitant with multiple RAAs most likely had an idiopathic cause because the patient had no history of trauma or other probable causes, such as procedure-related renal injury. Furthermore, hemodynamic changes, such as hyperdynamic circulation in pregnancy and hormonal changes, may contribute to the formation of aneurysms 7 because the patient was pregnant 3 years ago.…”

Section: Discussionmentioning

confidence: 73%

Hypertension Caused by Renal Arteriovenous Fistula with Multiple Renal Artery Aneurysms

Zhou

Cui

Zhao

et al. 2021

Annals of Vascular Surgery

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“…Open surgery alternatives are local reconstruction with arteriorrhaphy, patch closure, interposition graft, or bypass. There are reports of simple closure of the rupture site and excision of the graft without reconstruction that have been well tolerated [42–47]. Ureter repair is performed by reimplanting the ureter away from the vessels or by placing a nephrostomy tube.…”

Section: Discussionmentioning

confidence: 99%

Massive hematuria due to an autogenous saphenous vein graft and urinary bladder fistula in an extra-anatomic iliofemoral bypass: a case report

et al. 2019

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IntroductionGross hematuria caused by rupture of an artery in the urinary tract is a rare but potentially fatal condition. Iliac artery aneurysms, pelvic surgery with radiation, vascular reconstructive surgery, surgery for stenosis of the ureteropelvic junction, and transplantation are reported to be associated with this condition. In the vascular reconstructive surgery group, the most common etiology is rupture of the degenerated artery or synthetic graft in the ureter.Case presentationWe present a case of rupture of the small anastomotic pseudoaneurysm at the proximal anastomosis of a right iliofemoral autogenous vein extra-anatomic graft in the urinary bladder. To our knowledge, this is the first report of a rupture of an autogenous vein graft in the urinary bladder. Our patient, a 24-year-old Albanian farmer, was admitted to the emergency department in severe hemorrhagic shock induced by exsanguinating hematuria. He underwent immediate surgery, during which direct sutures to the bladder were placed and the saphenous graft was replaced with a synthetic one. The patient recovered completely, was free of hematuria, and showed no signs of pathological communication between the urinary and arterial tracts on postoperative cystoscopy and computed tomographic angiography during 2 years of follow-up.ConclusionThe incidence of artery-to-urinary tract fistulas is growing due to the increasing use of urologic and vascular surgery, pelvic oncologic surgery, and radiation therapy. In addition to fistulas involving a degenerated artery and ureter or synthetic grafts and ureter, they can also involve an autogenous vein graft and the urinary bladder. In our patient, the fistula was a result of erosion of the bladder from a pseudoaneurysm at the proximal anastomosis of an autogenous vein iliofemoral bypass in an extra-anatomic position. Open surgery remains the best treatment option, although there is increasing evidence of successful endovascular treatment.

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Ruptured renal arteriovenous malformation successfully treated by catheter embolization: a case report

Cited by 12 publications

References 6 publications

Renal Arteriovenous Shunts: Clinical Features, Imaging Appearance, and Transcatheter Embolization Based on Angioarchitecture

Renal Arteriovenous Shunts: Clinical Features, Imaging Appearance, and Transcatheter Embolization Based on Angioarchitecture

Hypertension Caused by Renal Arteriovenous Fistula with Multiple Renal Artery Aneurysms

Massive hematuria due to an autogenous saphenous vein graft and urinary bladder fistula in an extra-anatomic iliofemoral bypass: a case report

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