title: Giant idiopathic renal arteriovenous fistula managed by coils and amplatzer device: Case report and literature review.
abstract: An idiopathic renal arteriovenous (AV) fistula is a rare malformation of the kidney that may present insidiously with heart failure or hematuria. The treatment may be challenging due to large fistula size that may limit endovascular management. The authors report a case of an 85-year-old Caucasian woman who presented with acute heart failure and was found to have a right renal AV fistula. Since she had no prior history of renal intervention or trauma, a diagnosis of idiopathic renal AV fistula was made. She was managed by endoluminal occlusion using multiple stainless steel coils and Amplatzer vascular plug II device. The follow-up computed tomography showed complete occlusion of the fistula. This report highlights the late presentation of this rare disease and presents the utility of the combination of coils and Amplatzer device for management of a large fistula. It also reiterates that even if large, these fistulas can be managed by endovascular occlusion.
authors.affiliation: Prashant Nagpal, Girish Bathla, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
authors.forename: Prashant
authors.initials: P
authors.lastname: Nagpal
authors.affiliation: Prashant Nagpal, Girish Bathla, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
authors.forename: Girish
authors.initials: G
authors.lastname: Bathla
authors.affiliation: Prashant Nagpal, Girish Bathla, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
authors.forename: Sachin S
authors.initials: SS
authors.lastname: Saboo
authors.affiliation: Prashant Nagpal, Girish Bathla, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
authors.forename: Ashish
authors.initials: A
authors.lastname: Khandelwal
authors.affiliation: Prashant Nagpal, Girish Bathla, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Goyal
authors.affiliation: Prashant Nagpal, Girish Bathla, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Rybicki
authors.affiliation: Prashant Nagpal, Girish Bathla, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Steigner
keywords: Amplatzer device; Arteriovenous fistula; Endovascular management; Heart failure; Idiopathic