Endovascular Management of a Traumatic Renal-caval Arteriovenous Fistula in a Pediatric Patient

Kuy, SreyRam; Rossi, Peter J.; Seabrook, Gary R.; Brown, Kellie R.; Lewis, Brian D.; Rilling, William S.; Martin, Gregory J.; Patel, Bhavin; Dua, Anahita; McMaster, Jason; Desai, Sapan S.; Lee, Cheong

doi:10.1016/j.avsg.2013.04.028

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…These have been successfully managed with stents, or depending on the vascular anatomy, with coils and other embolizing materials. [10][11][12][13] In this case, had there not been free intraperitoneal fluid, which mandated exploration, the patient would have been managed in the angiography suite primarily. At the time of laparotomy, no bowel injury was found, and the hematoma over the renal vessels and the portal triad, though tense, was not increasing and the patient remained stable.…”

Section: Discussionmentioning

confidence: 98%

Hematomas in Tiger Territory

Teso

Rogoway

Vea

et al. 2017

Innovations�(Phila)

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A 26-year-old man presented with gunshot wound to the epigastrium. At surgery, he was hemodynamically stable and had a tense hematoma with thrill in zone 2 (right side) and porta triad. After liver injury was controlled, he underwent percutaneous stenting of a renal artery-vena cava fistula and the hepatic artery injury was followed. Historically, penetrating injury to zone 2 has mandated operative exploration. However, with the advent of endovascular options, in stable patients, catheter-based options offer a reasonable alternative with less risk of blood loss and possible nephrectomy. Renal artery stenting has been advocated for renal artery cava fistulas. The role of timing, hybrid operating suites, and traditional operative exposure will vary based on presentation and institutional capabilities.

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Section: Discussionmentioning

confidence: 98%

Hematomas in Tiger Territory

Teso

Rogoway

Vea

et al. 2017

Innovations�(Phila)

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“…There has been a shift toward endovascular management of renal arteriovenous fistulae. 10,12,13 Endovascular repair offers a less morbid treatment option in the high-surgical risk patient. Transcatheter embolization can be used to treat many different arteriovenous fistulae throughout the body and was successfully used to treat a renal arteriovenous fistula in our patient.…”

Section: Discussionmentioning

confidence: 99%

Management of Renal Artery-Inferior Vena Cava Fistula Following Nephrectomy for Penetrating Trauma

Mikhail

Ferral

Smith

et al. 2022

Vasc Endovascular Surg

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Background: Renal artery to inferior vena cava fistula is a rare event postnephrectomy. We report a case of an adult male in whom a renal artery to inferior vena cava fistula was detected on non-invasive studies following nephrectomy for penetrating trauma. Case Report: A fistula between the right renal artery and inferior vena cava was confirmed with diagnostic angiography. The fistula was successfully embolized using microcoils. Discussion: This case highlights the importance of exploring retroperitoneal hematomas secondary to penetrating trauma.

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“…Erosion of arterial wall into the adjacent vein leading to the fusion of the vessel walls is considered the underlying pathophysiological mechanism [13,14]. Acquired RAVF is the most common sub-type and is considered a sequel of iatrogenic, blunt or even penetrating renal trauma [15][16][17][18][19][20]. Less frequent pathologies causing RAVF development include malignancy with tumor neovascularity [14] and/or focal inflammation of the vessel wall [2].…”

Section: Discussionmentioning

confidence: 99%

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

Rhee

Busch²,

Sansone³

et al. 2019

Case Reports in Vascular Medicine

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Purpose. To report the effectiveness of left renal artery (LRA) occlusion using Amplatzer Vascular Plug (AVP) II as treatment for a high-flow renal arteriovenous fistula (RAVF) with multiple renal vein aneurysms (RVA) to prevent aneurysm rupture and cardiac decompensation. Case Report. A 59-year-old female suffering from a post-traumatic RAVF presented with tachycardia and increased cardiac output (CO). Doppler ultrasonography and computed tomography (CT) scan revealed a high-flow RAVF with multiple RVAs and unilateral critically reduced kidney function. Appreciating recent interventional therapeutic advances, the patient was treated with endovascular placement of AVP II into the left renal artery (LRA) resulting in complete occlusion of the RAVF to effectively reduce the risk of RVA rupture and cardiac decompensation. No anti-platelet medication was administrated after the occlusion of the LRA. The patient’s physical capacity improved since right heart volume strain was normalized, and CO was reduced. Conclusion. Transbrachial AVP II occlusion of the LRA is effective to occlude high-flow RAVFs to prevent risk of life-threatening RVA rupture. Additional follow-up is warranted to verify long-term effectiveness of this approach.

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Endovascular Management of a Traumatic Renal-caval Arteriovenous Fistula in a Pediatric Patient

Cited by 7 publications

References 16 publications

Hematomas in Tiger Territory

Hematomas in Tiger Territory

Management of Renal Artery-Inferior Vena Cava Fistula Following Nephrectomy for Penetrating Trauma

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

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