L'Huillier Romain, Pagnoux Gaële, Dupuis-Girod Sophie, Stacoffe Nicolas
Department of Diagnostic and Interventional Radiology, Hospices Civils de Lyon, University of Lyon, Pavillon B, Hôpital Edouard Herriot, 5 Place D'Arsonval, Lyon, 69003, France.
LabTAU - Inserm U1032, Lyon, 69003, France.
CVIR Endovasc. 2024 Mar 16;7(1):30. doi: 10.1186/s42155-024-00444-8.
Renal arteriovenous malformation (AVM) in Hereditary Hemorrhagic Telangiectasia (HHT) is uncommon and only few cases have been described, mainly with surgical management because of uncontrolled hematuria.
We managed a 70-year-old patient with HHT who presented with hematuria and left flank pain. Computed Tomography and ultrasound showed left renal AVM of 18 mm with clotting in the urinary tract. An external ureteral catheter was placed during 3 days to allow rinsing and facilitate elimination of clots. Given the patient's hemodynamic stability, a non-surgical management was chosen. Treatment of the AVM was performed by trans-arterial embolization using micro-coils and ethylene-vinyl alcohol copolymer.
Our case study shows a conservative management by embolization of ruptured left renal AVM revealed by hematuria in a 70-year-old patient with HHT.
遗传性出血性毛细血管扩张症(HHT)中的肾动静脉畸形(AVM)并不常见,仅有少数病例被描述,主要因血尿难以控制而行手术治疗。
我们诊治了一名70岁的HHT患者,其表现为血尿和左胁腹痛。计算机断层扫描和超声显示左肾有一个18毫米的AVM,尿路中有血凝块。放置了外置输尿管导管3天,以便冲洗并促进血凝块排出。鉴于患者血流动力学稳定,选择了非手术治疗。采用微线圈和乙烯-乙烯醇共聚物经动脉栓塞治疗AVM。
我们的病例研究表明,对于一名70岁HHT患者因血尿发现的破裂左肾AVM,可通过栓塞进行保守治疗。