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Transarterial treatment of congenital renal arteriovenous fistulas

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Presentation on theme: "Transarterial treatment of congenital renal arteriovenous fistulas"— Presentation transcript:

1 Transarterial treatment of congenital renal arteriovenous fistulas
Naiem Nassiri, MD, Yuriy Dudiy, MD, Alfio Carroccio, MD, Robert J. Rosen, MD  Journal of Vascular Surgery  Volume 58, Issue 5, Pages (November 2013) DOI: /j.jvs Copyright © 2013 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Arteriovenous malformation (AVM) featuring a nidus typically seen in extremity lesions (A). Arteriovenous fistula (AVF) featuring single arterial feeder with branches shunting into and aneurismal draining vein (B). The latter is more commonly found in the pulmonary circulation in patients with hereditary hemorrhagic telangiectasias (HHT) or congenital renal arteriovenous fistulas (CRAVFs). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Flush aortography demonstrates enlarged ipsilateral renal artery (black arrow) (A and B), poor parenchymal visualization compared with nonaffected side, an aneurismal draining vein (white arrow), and early detection of contrast within an enlarged vena cava (white star). Note the presence of bilateral congenital renal arteriovenous fistula (CRAVFs) in a patient with horseshoe kidney (C). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Selective (A and B) and superselective (C) renal arteriography demonstrating a dilated, tortuous arterial feeder (A and B) (black arrow) shunting into a rapid-filling aneurismal vein (white arrow). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Completion angiography after coils (A), n-butylcyanoacrylate (n-BCA) cast (B), and Amplatzer vascular plug II (C) embolization (black arrow) of the arteriovenous fistula (AVF). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

6 Fig 5 Balloon-flow control of a renal arteriovenous fistula (AVF).
Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

7 Fig 6 Digital subtraction angiography following glue-embolization reveals successful elimination of the shunt with approximately <25% renal parenchymal loss at the lower pole. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

8 Fig 7 Computed tomography angiography (CTA) demonstrating a dramatically aneurismal draining vein in a patient with CRAVF. This was initially diagnosed as a renal artery aneurysm at an outside facility (A). Postembolization CT scan (different patient) at 1 month (B) and 12 months (C) demonstrates complete devascularization and gradual shrinkage of the draining vein, which featured a rim of calcium (B). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

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