Ohashi Tomoyoshi, Nishikimi Toshinori, Hattori Kyosuke, Yamauchi Yushi, Ishida Ryo, Yamada Hiroshi, Yokoi Keisuke, Kobayashi Hiroaki
Department of Urology, Nagoya Daini Red Cross Hospital.
Nihon Hinyokika Gakkai Zasshi. 2018;109(2):116-121. doi: 10.5980/jpnjurol.109.116.
A 60-year-old man presented with leg edema and shortness of breath. He was being treated with medication for chronic heart failure for the past 3 years and had been in a traffic accident when he was 13 years old. Computed tomography showed a huge right renal arteriovenous fistula (AVF). The right renal artery measured 16 mm in diameter, the renal aneurysm was observed to be 60 mm, renal vein 87 mm, and the inferior vena cava 60 mm in diameter. His high-output heart failure was attributed to his right renal AVF, for which treatment was deemed necessary. Due to the risk of pulmonary embolism associated with transcatheter arterial embolization, we performed a nephrectomy with temporary interruption of renal blood flow using a balloon catheter. He was observed to be asymptomatic immediately after surgery.
一名60岁男性出现腿部水肿和呼吸急促。在过去3年中，他一直在接受慢性心力衰竭的药物治疗，13岁时曾遭遇交通事故。计算机断层扫描显示巨大的右肾动静脉瘘（AVF）。右肾动脉直径为16毫米，观察到肾动脉瘤为60毫米，肾静脉为87毫米，下腔静脉直径为60毫米。他的高输出量心力衰竭归因于右肾AVF，因此认为有必要进行治疗。由于经导管动脉栓塞术存在肺栓塞风险，我们使用球囊导管进行了肾切除术，并临时阻断肾血流。术后他立即被观察到无症状。
