Intraoperative balloon catheter control of renal arteriovenous fistula.
Renal arteriovenous fistulas have been managed with embolic therapy or surgical excision. In the case of a large, hemodynamically significant shunt sudden occlusion of the renal artery may result in profound circulatory decompensation. We managed such a case with a combined approach. An intra-arterial balloon catheter was inserted into the renal artery under fluoroscopic guidance, with constant monitoring of the central cardiac indexes via a Swan-Ganz line. The balloon was inflated and then released as circulatory changes were corrected. Once the patient was stable we performed a simple nephrectomy. We recommend this combined, controlled approach for the management of large arteriovenous fistulas.
D000368:Aged; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D004621:Embolization, Therapeutic; D006801:Humans; D008297:Male; D009392:Nephrectomy; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging; D012082:Renal Veins / Q000000981:diagnostic imaging