Duc V T, Duong Nqt, Phong N T, Nam N H, Quoc D A, Cuong Ttq, Huy N H, Duy T L, Chien P C
Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam.
Radiol Case Rep. 2021 Jun 18;16(8):2289-2294. doi: 10.1016/j.radcr.2021.05.058. eCollection 2021 Aug.
Renal arteriovenous fistula (RAVF) is an uncommon vascular malformation of the kidney, which can be congenital, acquired or idiopathic. Although most patients are asymptomatic, RAVF can lead to hypertension, heart failure, renal insufficiency, hematuria, and progressive increase in size of renal vessels. Diagnosis is aided by radiological studies, with digital subtraction angiography as a gold standard. Besides, ultrasound with color Doppler and computed tomography angiography are noninvasive imaging techniques and can be useful for planning the treatment. A large fistula are generally treated by nephrectomy. Intervention can ameliorate the hemodynamic effects of high flow and to preserve the renal parenchymal function. Although endovascular therapy may be challenging due to the large size and high flow of fistula, this report describes a case of huge RAVF was successfully treated by embolization instead of surgery.
肾动静脉瘘(RAVF)是一种罕见的肾脏血管畸形,可分为先天性、后天性或特发性。尽管大多数患者无症状,但肾动静脉瘘可导致高血压、心力衰竭、肾功能不全、血尿以及肾血管大小逐渐增加。放射学检查有助于诊断,数字减影血管造影是金标准。此外,彩色多普勒超声和计算机断层血管造影是非侵入性成像技术,可用于治疗方案的规划。较大的瘘通常通过肾切除术治疗。干预可改善高流量的血流动力学效应并保留肾实质功能。尽管由于瘘的尺寸大且流量高,血管内治疗可能具有挑战性,但本报告描述了一例巨大肾动静脉瘘通过栓塞而非手术成功治疗的病例。