Endovascular Occlusion of a Renal Arteriovenous Fistula with Renal Vein Aneurysm Formation for Rupture Prevention

Figure 1

Clinical finding and imaging prior to renal arterio-venous fistula (RAVF) occlusion. (a) Electrocardiogram (ECG) with sinus tachycardia in precordial right heart leads V1–3. No pathological ECG intervals. (b) multiple renal vein aneurysm (RVA) with broadening of spectral waveforms suggesting arterial aneurysm perfusion. (c) Renal scintigraphy (MAG-3) found a split renal function of left: 33% vs. right: 67% since a proximal high-flow RAVF caused reduced kidney perfusion. (d) 3D and coronal reconstruction. RVA (blue arrows, dashed) which are likely to be a long-term sequalae from a proximal high-flow RAVF. Recognize the straight proximal segment of the left renal artery (LRA) (red arrow, dashed, and dotted) for Amplatzer Vascular Plug (AVP) placement. Recognize the diameter enlargement of the Inferior Vena Cava (IVC) (green arrow, dotted) caused by increased volume load.

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