Transcatheter occlusion of the arterial supply to arteriovenous fistulas with Gianturco coils.

Transcatheter occlusive therapy is finding widespread clinical application. Numerous types of occlusive devices have been described. This report details the first three cases of occlusion of the arterial supply to arteriovenous fistulas with Gianturco stainless steel coils. Patients benefiting from this approach include those who refuse or cannot tolerate surgery, those in whom previous surgery failed, and those with chronic fistulas in whom surgery is likely to fail. The angiographer should make sure the coil is completely within the desired vessel, the feeding vessel is smaller than the coil to prevent passage through the fistula, and there is adequate collateral flow to distal organs to prevent infarction after occlusion of a major artery. This technique is useful as a nonsurgical treatment for a variety of arteriovenous fistulas and is within the capability of any experienced angiographer.