Superselective Arterial Embolization of Arteriovenous Malformation of Internal Pudendal Artery, a Rare Cause of Hematuria: A Case Report

Abstract

Arteriovenous malformation (AVM) is a common form of vascular malformation, an abnormal direct communication between an artery and a vein without passing through the capillaries. AVM may just present as hematuria without plain or other symptoms. The article presents a case of a 52-year-old male with gross hematuria diagnosed as AVM of internal pudendal artery, which was successfully managed with superselective arterial embolization using temporary embolization materials.

Congenital periprostatic pelvic arteriovenous malformation presenting as isolated pelvic pain and requiring endovascular embolization

“…CT angiography is useful in determining the vascular anatomy and defining the extent of lesions during assessment and can also characterize progression and recurrence during follow-up. [1][2][3][4][5][6][7] In the case described here, when a cause for symptoms remained unexplained following initial imaging, MRI proved useful. This modality can identify subtle a with high resolution.…”

“…Transrectal Doppler ultrasonography is an appropriate first line imaging modality for detecting periprostatic AVMs 1–3,7 . It is generally well tolerated and avoids the use of intravenous contrast at low cost 5 .…”

“…MRI may also help define local anatomy for surgical planning. [2][3][4]7 Selective invasive arteriography and venography is gold standard for characterizing vascular anatomy and is particularly useful in diagnosing and defining AVMs where complex, often multiple arterio-venous lesions are present. This modality is useful in the therapeutic setting when guiding embolization or the planning of surgical treatment of AVMs.…”

“…This modality is useful in the therapeutic setting when guiding embolization or the planning of surgical treatment of AVMs. 2,3,[5][6][7] Treatment is recommended for symptomatic or enlarging AVMs. Embolization is preferred to surgical ligation due to the complexity of pelvic anatomy or involvement of main vessels.…”

“…Embolization is preferred to surgical ligation due to the complexity of pelvic anatomy or involvement of main vessels. [1][2][3][4][5][6][7][8] Owari et al 4 proposed embolization of an AVM prior to definitive treatment of localized prostate cancer, however, advised caution for the potential of inducing radio-resistance. Incomplete embolization of a lesion is a well-recognized cause for recurrence requiring repeat procedures or a combination of techniques.…”