89. Renal arteriovenous fistula: A reversible cause of hypertension and heart failure

Maldonado, Jorge E.; Sheps, Sheldon G.; Bernatz, Philip E.; DeWeerd, James H.; Harrison, Edgar G.

doi:10.1016/0002-9149(64)90319-4

Cited by 21 publications

(25 citation statements)

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“…Renal AVMs provoking haematuria are usually located in the peripelvic region, necessitating extensive branch artery dissection with high risk of renal parenchymal damage. It is therefore not surprising that in the past, only rAVMs producing severe symptoms (congestive heart failure, malignant hypertension, severe recurrent haematuria) were elected for surgical treatment, which mostly resulted in nephrectomy [6,7,11]. Transcatheter embolization replaces open surgery and, occasionally, obviates the need for general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Cirsoid renal arteriovenous malformation treated by endovascular embolization with n-butyl 2-cyanoacrylate

et al. 2000

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Section: Discussionmentioning

confidence: 99%

Cirsoid renal arteriovenous malformation treated by endovascular embolization with n-butyl 2-cyanoacrylate

et al. 2000

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“…There is some evidence of hypoperfusion of the parenchyma in such kidneys. The pattern of hypoperfusion has recently been described in a patient with arterio-venous fistula in the kidney (Maldonado, Sheps, Bernatz, de Weerd & Harrison, 1964). Arteriograms of kidneys with an arterio-venous fistula (Boijsen & K~h l e r , 1962;Edsman, 1957) clearly show decreased density of the roentgen contrast medium in the part of the kidney harbouring the fistula, probably due to hypoperfusion of the surrounding renal parenchyma.…”

Section: Discussionmentioning

confidence: 90%

Renal Function Studies in Renal Carcinoma

Ofstad

Kolsaker

1970

Clinical Science

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1. In ten patients with renal cell carcinoma (Grawitz tumour) a selective kidney function study was performed with the intention of measuring the effect of the tumour upon the function of the parenchyma surrounding the tumour.2. The excretion fraction of sodium and chloride and the osmolal clearance per unit of glomerular filtrate were significantly less and the urinary concentration of inulin and para-amino-hippuric acid were significantly greater in the affected than in the non-affected kidneys. In three patients with poorly vascularized tumours the difference between the affected and the non-affected kidney was insignificant or small.3. The findings indicate hypoperfusion of the parenchyma surrounding the tumour. The hypoperfusion may be caused by diversion of circulating blood from the parenchyma to the tumour.4. There was no correlation between the occurrence and degree of hypoperfusion and the blood pressure.

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“…As long as the arteriovenous fi stula is caused by needle renal biopsy, pseudoaneurysm does not usually develop. In such a case, the arteriovenous fi stula manifests dominantly as a hyperkinetic blood circulation that particularly in older patients may eventually lead to cardiac failure (Maldonado et al, 1964, Voiculescu et al, 2003. Haemodynamic alterations induced by arteriovenous fi stula in the kidney include ischaemia of renal parenchyma distally to the fi stula with subsequent diastolic hypertension.…”

Section: Resultsmentioning

confidence: 99%

Arterio-venous fistula with pseudoaneurysm of renal artery

Breza

Javorka²,

Mizickova³

et al. 2012

BLL

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Introduction:The authors describe a rare but potentially severe, sometimes even life-threatening complication occurring after various invasive renal interventions. The cause that gives rise to a fi stula formation between close branches of renal artery and vein is an injury of these vessels during resection of a localised renal tumour, renal biopsy, percutaneous nephrostomy, and even blunt injury of the kidney. Blood fl ows under pressure from renal artery, pushes the surrounding renal parenchyma open, and creates a cavity varying in size and shape. This pseudoaneurysm may communicate with the collecting system of the kidney, in which case it may lead to haematuria, one of the typical symptoms of arteriovenous fi stula. Material and methods:The authors observed this complication in 8 patients (6 males aged from 56 to 70, average 61.7, and two females aged 28 and 54). In 7 patients, the fi stula developed after resection of a localised renal tumour, in one patient after percutaneous nephrolitholapaxy of a stone in the kidney. The fi stulae manifested themselves between 7 an 21 days after surgery by massive haematuria in 4 patients and by intermittent macroscopic haematuria in 3 patients. In one patient the fi stula was asymptomatic while the pseudoaneurysm at the place of pathological connection of renal veins was found during ultrasonographic examination after renal resection. Results: In all patients, the diagnosis of arteriovenous fi stula and pseudoaneurysm of renal artery was achieved by ultrasonographic and/or CT examinations. The highest diagnostic value can be ascribed to digital subtraction renoangiography by Seldinger method that subsequently allowed active treatment by introducing an endovascular coil. By this method we cured 5 fi stulae. In two patients, urgent nephrectomies were needed because of massive life-threatening haematuria. One of arteriovenous fi stulae underwent spontaneous thrombosis. Conclusion: The symptomatic arteriovenous fi stula requires fast and precise diagnosis subsequently enabling effi cient treatment. Endovascular manipulation is a method allowing the preservation of kidney affected by arteriovenous fi stula with renal artery pseudoaneurysm (Fig. 7, Ref. 21). Full Text in PDF www.elis.sk.

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89. Renal arteriovenous fistula: A reversible cause of hypertension and heart failure

Cited by 21 publications

References 0 publications

Cirsoid renal arteriovenous malformation treated by endovascular embolization with n-butyl 2-cyanoacrylate

Cirsoid renal arteriovenous malformation treated by endovascular embolization with n-butyl 2-cyanoacrylate

Renal Function Studies in Renal Carcinoma

Arterio-venous fistula with pseudoaneurysm of renal artery

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