医学
栓塞
肾动脉
动静脉瘘
动静脉畸形
血管造影
数字减影血管造影
放射科
外科
动脉栓塞
肾盂
骨盆
肾
内科学
输尿管
作者
Shulian Chen,Guangjie Li,Hui Zhou,Guobiao Liang,Xu Luo,Zeju Zhao
出处
期刊:Urologia Internationalis
[S. Karger AG]
日期:2022-02-14
卷期号:107 (2): 214-218
被引量:1
摘要
Renal arteriovenous malformation (RAVM) is a rare pathology. It may present with heamturia, hypertension, and congestive heart failure. Digital subtraction angiography (DSA) is the standard diagnostic choice, and endovascular embolization is a preferred procedure of management in most cases. The feeding branches of RAVM are reported to originate from renal arteries. In this report, a 43-year-old female with recurrent massive hematuria and left flank pain was described. Renal angiography revealed double renal arteries supplying the left kidney and multiple renal arteriovenous fistula formation around the renal pelvis. Embolization with coils and gelfoam was performed after which her hematuria subsided. One month later, the patient was readmitted to our hospital due to the relapse of massive hematuria following heavy physical activities. DSA found another feeding artery of the RAVM originating from the aorta around the 4th lumbar vertebra. After embolization of this arterial feeder, hematuria settled. There was no recurrence during a 10-month follow-up. To our knowledge, this is the first case of RAVM with an extrarenal feeding artery, and omission of this scenario can lead to treatment failure.
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