title: Transarterial embolisation of renal arteriovenous malformation: safety and efficacy in 24 patients with follow-up.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of renal artery embolisation (RAE) for renal arteriovenous malformation (AVM) as well as its outcomes.
  
  
  METHODS
  The technical and clinical success rates, radiological and laboratory findings, and complications of RAE for 31 renal AVMs in 24 patients (M:F=9:15, mean age 46 years) at two separate medical institutions were retrospectively evaluated. Technical success was defined as complete occlusion of feeding arteries with no residual nidus seen on post-treatment angiography. Clinical failure was defined as recurrence of haematuria, presence of AVM on follow-up ultrasound or computed tomography, repeated RAE or surgery for the control of haematuria. Overall clinical success was defined as resolution haematuria or disappearance of AVM on follow-up imaging after single or multiple sessions of RAE.
  
  
  RESULTS
  Types of renal AVM were AVM, arterio-venous fistula (AVF) with intranidal aneurysm, and acquired AVF in 19, 1, and 4 patients, respectively. 18 patients (75%) underwent a single session of RAE, while 6 patients (25%) had two or more sessions of RAE. The level of embolisation was feeder, segmental artery, and main renal artery in 28 (90%), 2 (6%), and 1 (4%) procedures, respectively. Coil, n-butyl 2-cyanoacrylate, and polyvinyl alcohol were the most frequently chosen embolic materials and were used in 19, 14, and 8 procedures, respectively. The clinical success rate after initial RAE was 67% (16/24). Overall clinical success rate, including multisession RAE, was 88% (21/24). The technical success rate of 31 procedures was 65% (20/31). Among 11 technical failures in 10 patients, 4 achieved clinical success without additional RAE, 3 underwent second session RAE to achieve clinical success, and 3 patients underwent nephrectomy due to recurrence.
  
  
  CONCLUSIONS
  RAE is a safe and effective treatment for renal AVM. Technical failure of RAE does not always lead to clinical failure and multiple embolisation sessions may be effective for recurrent renal AVM.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Eom
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: jhshin@amc.seoul.kr.
authors.forename: J H
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Cho
authors.affiliation: Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, South Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Nam
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: G-Y
authors.initials: GY
authors.lastname: Ko
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: H-K
authors.initials: HK
authors.lastname: Yoon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D021501:Flank Pain / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012077:Renal Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012082:Renal Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult