Banthia Ravi, Kumar Abhay, Prasad Raghunandan, Lal Hira
Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
BMJ Case Rep. 2021 Apr 23;14(4):e242347. doi: 10.1136/bcr-2021-242347.
We report a case of renal arteriovenous malformation (AVM) and describe its angioarchitecture and endovascular management. A 28-year-old male patient presented with visible painless haematuria. CT of the abdomen showed a right renal AVM. Digital subtraction angiography of the right renal vessels showed an AVM of middle and lower pole segmental arteries with communication to a large saccular aneurysm, which was arising from the right main renal vein. Complete occlusion of the AVM was done by using glue (a mixture of n-butyl-cyanoacrylate and lipiodol), resulting in nonvisualisation of the aneurysm on angiography. His vital signs were stable during the procedure. Follow-up CT after 12 months showed no residual flow in the aneurysm, normal upper pole renal parenchyma and nonvisualisation of AVM. Early diagnosis of this clinical entity is of paramount importance for proper management as it can cause massive blood loss and rapid clinical deterioration.
我们报告一例肾动静脉畸形（AVM）病例，并描述其血管结构及血管内治疗情况。一名28岁男性患者出现肉眼可见的无痛性血尿。腹部CT显示右肾AVM。右肾血管数字减影血管造影显示中下极节段动脉的AVM与一个源于右肾主静脉的大囊状动脉瘤相通。通过使用胶水（正丁基氰基丙烯酸酯和碘油的混合物）实现了AVM的完全闭塞，血管造影显示动脉瘤不显影。术中患者生命体征稳定。12个月后的随访CT显示动脉瘤无残余血流，上极肾实质正常，AVM不显影。对该临床实体的早期诊断对于恰当治疗至关重要，因为它可导致大量失血和快速的临床恶化。
