title: Endovascular treatment of arteriovenous fistulas complicating percutaneous renal biopsy in three paediatric cases.
abstract: METHODS
  We evaluated the incidence and history of arteriovenous fistula (AVF) after kidney biopsy and assessed the use of superselective embolization for treatment.
  
  
  METHODS
  During the last 10 years, 896 kidney biopsies (age range of the patients: 1 month-18.6 years) have been performed in our institution under real-time ultrasonographic guidance with a 14 gauge cutting biopsy needle, and 32 of the patients had renal allografts (3.4%). We observed three cases of AVF (two in allograft kidneys, one in a native kidney) among all biopsies (0.34%), and the incidence of developing AVF after renal allograft biopsy was 6.3%. All three patients with AVF were symptomatic, and intravascular therapy was indicated.
  
  
  METHODS
  An angiographic study combined with endovascular treatment of the intrarenal AVF and pseudoaneurysm was performed in all three patients. Embolization was performed with bucrylate and lipiodol in two patients and with micro-coils in one. After successful embolization, all three patients became asymptomatic (in two renal bleeding stopped, in one patient with severe uncontrollable hypertension blood pressure returned to normal limits). No complications were observed secondary to the embolization procedure.
  
  
  CONCLUSIONS
  The technique of superselective embolization using a coaxial catheter is an effective and safe method in the treatment of post-biopsy AVFs and pseudoaneurysm.
authors.affiliation: Department of Pediatric Nephrology, University of Istanbul, Istanbul Medical Faculty, Istanbul, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Bilge
authors.forename: I
authors.initials: I
authors.lastname: Rozanes
authors.forename: B
authors.initials: B
authors.lastname: Acunas
authors.forename: O
authors.initials: O
authors.lastname: Minareci
authors.forename: A
authors.initials: A
authors.lastname: Nayir
authors.forename: F
authors.initials: F
authors.lastname: Oktem
authors.forename: E
authors.initials: E
authors.lastname: Tonguç
authors.forename: Y
authors.initials: Y
authors.lastname: Kozok
authors.forename: S
authors.initials: S
authors.lastname: Emre
authors.forename: H
authors.initials: H
authors.lastname: Ander
authors.forename: A
authors.initials: A
authors.lastname: Sirin
authors.forename: A
authors.initials: A
authors.lastname: Poyanli
mesh_terms: D000293:Adolescent; D017541:Aneurysm, False / Q000209:etiology / Q000628:therapy; D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D001706:Biopsy / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000473:pathology; D008297:Male