Mansueto Giancarlo, D'Onofrio Mirko, Gasparini Anna, Procacci Carlo
Dipartimento di Scienze Morfologico-Biomediche, Istituto di Radiologia, Policlinico G. B. Rossi, Verona, Italy.
Radiol Med. 2003 Mar;105(3):195-204.
To describe the morphological and haemodynamic characteristics of high-flow idiopathic renal arteriovenous fistulas and the radiological treatment techniques.
Two cases of idiopathic renal arteriovenous fistula were treated with transcatheter embolization. In the first case, the anomalous arteriovenous communication was embolized with acrylic glue through the afferent artery while the efferent vein was temporarily occluded with a balloon catheter using the "stop flow" technique. In the second case, the fistula was occluded from the arterial side using Gianturco coils and the "free flow" technique.
In both cases post-procedural angiography demonstrated occlusion of the fistula. A color-Doppler US examination 6 months later showed the regularization of flow parameters in the renal artery and vein. Angiographic follow-up showed occlusion of the arteriovenous fistula, regularization of the renal artery calibre and normal renal parenchymal flow.
Embolization is the best treatment for rare, high-flow, renal arteriovenous fistulas. The "stop flow" technique with acrylic glue is fast and economical. The "free flow" technique with coils is more expensive and complex, but just as effective.
描述高流量特发性肾动静脉瘘的形态学和血流动力学特征以及放射治疗技术。
对2例特发性肾动静脉瘘患者进行经导管栓塞治疗。第一例中，通过“停流”技术，经传入动脉用丙烯酸胶栓塞异常动静脉交通，同时用球囊导管暂时闭塞传出静脉。第二例中，使用Gianturco弹簧圈和“自由流”技术从动脉侧闭塞瘘管。
两例患者术后血管造影均显示瘘管闭塞。6个月后的彩色多普勒超声检查显示肾动脉和静脉血流参数正常化。血管造影随访显示动静脉瘘闭塞、肾动脉管径正常化和肾实质血流正常。
栓塞是治疗罕见的高流量肾动静脉瘘的最佳方法。用丙烯酸胶的“停流”技术快速且经济。用弹簧圈的“自由流”技术更昂贵且复杂，但同样有效。
