Iatrogenic arteriovenous fistula in a renal allograft: the result of a TAD guidewire injury.
A case is presented of an iatrogenic arteriovenous fistula developing in a renal allograft following guidewire manipulation during transplant renal artery angioplasty. Hyperdynamic flow through the fistula was causing a shunt of blood away from the renal cortex as demonstrated on sonography and scintigraphy. Selective embolization was performed, correcting the maldistribution of flow to the peripheral renal cortex. The diagnosis and difficulty in management of asymptomatic renal arteriovenous fistulae is also discussed.
Lee-Elliott
C
C
Department of Radiology, St. George's Hospital NHS Trust, London SW17 0QT, UK.
Khaw
K T
KT
Belli
A M
AM
Patel
U
U
D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007049:Iatrogenic Disease; D016030:Kidney Transplantation / Q000009:adverse effects*; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000002:abnormalities* / Q000293:injuries; D051437:Renal Insufficiency / Q000601:surgery; D012082:Renal Veins / Q000002:abnormalities* / Q000293:injuries; D014184:Transplantation, Homologous; D018608:Ultrasonography, Doppler