Staged endovascular occlusion of giant idiopathic renal arteriovenous fistula with platinum microcoils and silk suture threads.
Large symptomatic aneurysmal renal arteriovenous (AV) fistulas usually present with a flank bruit, uncontrolled hypertension, and high-output cardiac failure. Traditionally, these have been treated surgically because of the risk of inadvertent pulmonary embolism with use of embolization techniques. The authors report a case of a giant renal AV fistula successfully treated with staged embolization with use of metallic coils and silk suture. This resulted in a graded reduction in the extreme flow through the fistula, followed by delayed thrombosis and cure of the patient's symptoms.
Section of Vascular and Interventional Radiology, Harris Methodist Hospital, Fort Worth, Texas, USA. bgralino@ratc.com
B J
BJ
Gralino
Deborah L
DL
Bricker
D001164:Arteriovenous Fistula / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D006801:Humans; D019476:Insect Proteins; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010984:Platinum; D012077:Renal Artery; D012082:Renal Veins; D047011:Silk; D013536:Suture Techniques
D019476:Insect Proteins; D047011:Silk; D010984:Platinum