Kamai T, Saito K, Hirokawa M, Tukamoto H, Ashida H
Department of Urology, Fujisawa City Hospital, Kanagawa, Japan.
Urol Int. 1997;58(1):55-7. doi: 10.1159/000282948.
A cirsoid type of arteriovenous malformation was treated successfully by superselective embolization using a platinum micro coil and absorbable gelatin sponge. During the procedure, as soon as the arteriovenous shunt had disappeared, an arteriopelvic shunt appeared. The pyelogram showed that the high pressure arterial blood flow drained directly into the pelvic cavity. Massive gross hematuria occurred immediately accompanied by a sudden blood pressure drop to 60 mm Hg, necessitating blood transfusion. Fortunately this complication was managed successfully. To our knowledge, there are only a few reported cases that make reference to gross hematuria occurring on embolization. We discuss the possible causes of this complication and the mechanism of occurrence of gross hematuria in renal arteriovenous malformation.
采用铂微线圈和可吸收明胶海绵进行超选择性栓塞,成功治疗了蔓状型动静脉畸形。在手术过程中,动静脉分流一旦消失,就出现了动脉盆腔分流。肾盂造影显示高压动脉血流直接排入盆腔。随即出现大量肉眼血尿,同时血压突然降至60mmHg,需要输血。幸运的是,这一并发症得到了成功处理。据我们所知,仅有少数报道提及栓塞时发生肉眼血尿的病例。我们讨论了这一并发症的可能原因以及肾动静脉畸形中肉眼血尿的发生机制。