Percutaneous treatment of a traumatic renal-caval arteriovenous fistula presenting as high output cardiac failure.
A 67-year-old dialysis-dependent man presented to the cardiology service with worsening high output cardiac failure and was found to have a harsh, right-sided abdominal bruit on examination. Of significance, he had undergone several laparotomies related to a stab wound experienced 7 years earlier. A computed tomography scan revealed right renal artery pseudoaneurysms with fistulous communication to the vena cava. Successful percutaneous coil embolization and cyanoacrylate gluing enabled fistula closure without renal infarction. Symptoms of cardiac failure ultimately resolved following treatment. Catheter-based therapies provide minimally invasive and effective strategies for treating complicated fistulas involving the renal vasculature.
Robinson
Handel
H
Department of Vascular Surgery, Beth Israel Medical Center, New York, NY 10003, USA.
Shams
Joseph
J
Kirk
Jeffrey
J
Sorrentino
Nicole
N
Deitch
Jonathan
J
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016534:Cardiac Output, High / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D003487:Cyanoacrylates / Q000627:therapeutic use; D004621:Embolization, Therapeutic / Q000295:instrumentation; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D012077:Renal Artery / Q000000981:diagnostic imaging; D014014:Tissue Adhesives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D014951:Wounds, Stab / Q000150:complications* / Q000601:surgery
D003487:Cyanoacrylates; D014014:Tissue Adhesives