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Renal Arteriovenous Malformations: A Uncommon Vascular Reason behind Again Ache.
Ann Vasc Surg. 2017 Jul;42:62.e9-62.e11
Authors: Inui T, Frankel D
Summary
BACKGROUND: Renal arteriovenous malformation (AVM) is a really uncommon phenomenon (fewer than 200 circumstances within the literature), mostly (75%) presenting with hematuria in younger girls. Renal AVMs could also be cirsoid (multibranched) or cavernous, with cirsoid morphology predominating three:1. The historic remedy is partial nephrectomy. Finest endovascular remedy is split amongst many choices. We current 2 circumstances of huge renal AVMs handled with single Amplatzer plugs.
METHODS: Throughout a 2-year interval (2014-15), 2 sufferers introduced for vascular analysis of renal AVMs discovered by the way on workup for nonspecific stomach and again ache. Each had been the much less frequent cavernous-type AVM. Every famous again ache ipsilateral to the AVM. Neither had a historical past of trauma or renal procedures. Every underwent angiography and Amplatzer plug placement to occlude stream whereas preserving parenchyma.
RESULTS: Every affected person efficiently underwent occlusion of the arterial feeding department of the AVM with speedy angiographic success. Every affected person subsequently underwent follow-up imaging that demonstrated absence of filling of the AVM with preservation of wholesome renal parenchyma.
CONCLUSIONS: Renal AVMs, though very uncommon, do current to vascular surgeons and could also be managed efficiently by way of an endovascular method with normal strategies. Though renal AVMs are sometimes managed with cyanoacrylate embolization, cautious selective arterial catheterization permits for single plug embolization with glorious outcomes and with out requiring venous intervention.
PMID: 28341499 [PubMed – indexed for MEDLINE]