title: Management of postbiopsy arteriovenous fistulas in transplanted kidneys and effectiveness of endovascular treatment: a single-center experience.
abstract: BACKGROUND
  We sought to evaluate the best therapeutic management of postbiopsy arteriovenous fistulas (AVFs) in transplanted kidneys.
  
  
  METHODS
  Between January 2005 and December 2011, we observed 17 cases of postbiopsy AVF in transplanted kidneys (9 asymptomatic; 8 symptomatic). Asymptomatic cases were managed conservatively, while patients with symptomatic AVF underwent endovascular treatment. We used a technique that consisted in a superselective transcatheter embolization of the afferent branch. We evaluated the technical success (postoperative closure of AVF), the immediate clinical efficacy (cessation of symptoms), and clinical efficacy at follow-up (measurement of serum creatinine at 7 days and 6 and 12 months compared with preoperative levels using t-tests).
  
  
  RESULTS
  Asymptomatic AVFs resolved spontaneously, while the endovascular treatment in symptomatic AVFs showed a complete technical and clinical success with prompt remission of the presented symptoms. We observed a statistically significant reduction in serum creatinine at 7 days and 6 and 12 months postoperatively (mean creatinine--preoperative: 3.23 ± 1.4 mg/dL; 7 days: 2.25 ± 0.8 mg/dL; 6 months: 1.65 ± 0.28 mg/dL; 12 months: 1.4 ± 0.26 mg/dL; in all cases P < 0.05).
  
  
  CONCLUSIONS
  In our experience, asymptomatic AVFs could be managed conservatively with close follow-up while the endovascular treatment for symptomatic AVFs is both safe and effective in the short- and long-term.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Fossaceca
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Guzzardi
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy. Electronic address: cerini84@hotmail.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cerini
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Parziale
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Malatesta
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy.
authors.forename: Ivan
authors.initials: I
authors.lastname: Di Gesù
authors.affiliation: Departments of Clinical and Experimental Medicine, Nephrology and Transplantation and International Research Centre Autoimmune Diseases (IRCAD) of the Amedeo Avogadro University, Maggiore Hospital, Novara, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Quaglia
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Carriero
mesh_terms: D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D001706:Biopsy / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007558:Italy; D007668:Kidney / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D015415:Biomarkers; D003404:Creatinine