The Arab Journal of Interventional Radiology

: 2020  |  Volume : 4  |  Issue : 2  |  Page : 134--135

Embolization of high-flow renal arteriovenous fistula

Omar J AlThaqufi, Abdullah Mohammed Almughir, Fadhel Mohsen Almolani 
 Department of Interventional Radiology, King Fahad Specialist Hospital, Dammam, Saudi Arabia

Correspondence Address:
Dr. Omar J AlThaqufi
8951 2A, Firdaws District, Unit No. 4, Dammam 34251-5052
Saudi Arabia

How to cite this article:
AlThaqufi OJ, Almughir AM, Almolani FM. Embolization of high-flow renal arteriovenous fistula.Arab J Intervent Radiol 2020;4:134-135

How to cite this URL:
AlThaqufi OJ, Almughir AM, Almolani FM. Embolization of high-flow renal arteriovenous fistula. Arab J Intervent Radiol [serial online] 2020 [cited 2021 Mar 1 ];4:134-135
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Full Text

Dear Editor,

Endovascular embolization of aneurysmal-type renal arteriovenous malformation has inherent risk of migration of the embolic agents to the pulmonary arteries.

We report a case of a 49-year-old male who presented with hypertension and high-flow renal arteriovenous fistula (AVF) with dilated venous sac [Figure 1].{Figure 1}

Using a coaxial technique, a 4 mm × 11 mm Sceptor XC (Microvention) was advanced into the renal AVF. Despite maximal inflation of the balloon, which reached 6 mm, flow reduction was insufficient to prevent coil migration through the fistulous communication.

A 6 Fr balloon guide catheter (Cello, EV3) was used to slow flow through the shunt followed by a combination of n-BCA glue and coil embolization using Apollo microcatheter with detachable tip (Medtronic). A 2 ml of 90% n-BCA (2 ml histocryl mixed with 2mL of lipiodol) [Figure 2]. Then, 0.035-inch 15 mm × 40 cm and 8 mm × 40 cm interlock fibered coils (Boston Scientific) were deployed in the feeding artery. This was followed by injection of 2 ml of 25% precipitating hydrophobic injectable liquid embolic (Microvention), resulting in completion occlusion of the fistula. The patient recovered from the procedure with resolution of the hypertension [Figure 3].{Figure 2}{Figure 3}

The main complications of embolization of renal AVF include pulmonary embolism due to coil migration or thrombus from the aneurysmal venous sac thrombosis, renal vein thrombosis or inadvertent occlusion of the renal artery branches, and possible development of postembolization syndrome or renal dysfunction.

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Conflicts of interest

There are no conflicts of interest.