Successful Management of Postbiopsy Arteriovenous Fistula with Selective Arterial Embolization

Bookstein, Joseph J.; Goldstein, Harvey M.

doi:10.1148/109.3.535

Cited by 170 publications

(38 citation statements)

References 12 publications

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“…As for renal allografts, 22 arteriovenous fistulae complicated 309 biopsies (7%) in two series [5, 6](table 1). Arteriovenous fistulae after biopsy remain mostly asymptomatic, but may occasionally give rise to flank pain, gross hematuria, hypertension, arterial bruits, congestive heart failure, or even renal insufficiency [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27]. …”

Section: Discussionmentioning

confidence: 99%

“…More recently, embolization of arteriovenous fistulae under angiographic guidance has been used successfully in many patients [2, 3, 6, 10, 12, 13, 15, 16, 18, 23, 24, 25, 26, 27, 28, 29, 30](table 1). A review of many reports show that arterial embolization was successful in 23 of 25 (92%) arteriovenous fistulae in native kidneys and in 6 of 9 cases (67%) of allografts (table 2).…”

Section: Discussionmentioning

confidence: 99%

“…Arteriovenous fistulae and pseudoaneurysms may complicate renal biopsies; the frequency cited in the literature varies from less than 1 to 19% [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13]. Most of these lesions are asymptomatic, but a few may cause serious bleeding and require intervention.…”

Section: Introductionmentioning

confidence: 99%

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Life-Threatening Hematuria from an Arteriovenous Fistula Complicating an Open Renal Biopsy

Tarif

Dunne

Parachuru

et al. 1998

Nephron

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Arteriovenous fistulae and pseudoaneurysms are not rare after renal biopsy. The majority of these lesions (80%) are asymptomatic or show only transient symptoms. We present here a patient who developed life-threatening hematuria following an open renal biopsy. Arteriovenous fistula and pseudoaneurysm were detected in the biopsied kidney by color-coded Doppler sonography, confirmed by angiography, and the fistula was sealed by superselective arterial embolization with metallic coils. Color-coded Doppler sonography successfully detects the majority of arteriovenous fistulae after renal biopsy, and selective arterial embolization obviates the need for surgical intervention in most cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Life-Threatening Hematuria from an Arteriovenous Fistula Complicating an Open Renal Biopsy

Tarif

Dunne

Parachuru

et al. 1998

Nephron

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“…Transcatheter embolization of a renal arteriovenous fistula was first described in 1973. 19 Important considerations for percutaneous approach include access route (arterial or venous), materials required to close the fistula, and the avoidance of normal perfusing vessels.…”

Section: Discussionmentioning

confidence: 99%

The Thrill Is Gone

2015

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Foreword Information about a real patient is presented in stages (boldface type) to expert clinicians (Drs Beckman and Sobieszczyk), who respond to the information, sharing his reasoning with the reader (regular type). A discussion by the authors follows.A n 85-year-old white woman with longstanding atrial fibrillation and hypertension presented to our emergency department with a 2-day history of progressive dyspnea. Earlier that week she had been seen by an outpatient provider and was found to be hypotensive. Her home bumetanide was discontinued, and she developed dyspnea that progressed after missing 2 doses. She reported that she was sleeping with more pillows and that she had a limited ability to walk and a new cough.Her recent history was notable for progressive fatigue and dyspnea over the past year. In the past 3 months she had been treated as an outpatient with loop diuretics for presumed congestive heart failure by a cardiologist. Her recent history was also notable for recurrent hematochezia requiring 5 admissions, including an intensive care unit admission for hemorrhagic shock, over the preceding 6 months. An extensive evaluation, including esophagastroduodenoscopy, several colonoscopies, and a small-intestine capsule study were unrevealing; she was noted only to have severe diverticulosis. During this period, her warfarin and, after additional bleeding episodes, her aspirin were stopped in light of her recurrent bleeding.Additional medical history included a diagnosis of cataracts, macular degeneration, and osteoarthritis. Medications included bumetanide 1 mg daily, metoprolol succinate 50 mg daily, omeprazole 40 mg daily, and calcium supplements. She had no known drug allergies.Dr Beckman: Dyspnea in an older patient is a common concern and is predominantly caused by a range of cardiopulmonary diseases. In this case, the patient's presentation is notable for progressive dyspnea over 1 year that has acutely worsened over several days. Her report of orthopnea, cough, and exertional intolerance suggest that an exacerbation of congestive heart failure is likely. Moreover, her diagnosis of congestive heart failure is only presumed, and further investigation is needed to understand this acute presentation. Other etiologies of progressive dyspnea include anemia related to her recent gastrointestinal bleeding, or a primary pulmonary process such as interstitial lung disease, chronic obstructive pulmonary disease, malignancy, pulmonary hypertension, or an infectious process such as a viral respiratory infection or pneumonia. Patient presentation (continued):Initial vital signs on presentation included an oral temperature of 95°F, a heart rate of 81 beats per minute, blood pressure of 110/56 mm Hg, respiratory rate of 20 breaths per minute, oxygen saturation of 85% on room air with improvement to 95% on 3 L nasal cannula oxygen supplementation. Physical examination was notable for a cachectic-appearing woman in no acute distress. Her neck examination revealed marked internal jugular venous engorgement with v...

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“…Selective renal artery' embolization was first used to control hemorrhage in 1973 [3]. However, moderate to large volume loss of renal tissue occurred after successful se lective renal artery embolization [4], Other com pi icat ions of select ive em bol izat ion were hypertension, postembolization syndrome and shunting of embolic material into the pulmonary circulation.…”

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confidence: 99%

Superselective Embolization in the Treatment of Active Bleeding after Percutaneous Renal Biopsy

Sb¹,

Joó²,

Hc³

et al. 1996

Nephron

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Successful Management of Postbiopsy Arteriovenous Fistula with Selective Arterial Embolization

Cited by 170 publications

References 12 publications

Life-Threatening Hematuria from an Arteriovenous Fistula Complicating an Open Renal Biopsy

Life-Threatening Hematuria from an Arteriovenous Fistula Complicating an Open Renal Biopsy

The Thrill Is Gone

Superselective Embolization in the Treatment of Active Bleeding after Percutaneous Renal Biopsy

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