Successful surgical treatment with ex vivo technique in a patient with renal artery aneurysm rupture and bilateral arteriovenous fistula

Abstract

Renal arteriovenous fistulas are pathologic communications between the renal arteries and veins without interconnecting capillaries. Reports on the combination of fibromuscular dysplasia, aneurysms, and renal arteriovenous fistula are extremely rare in the literature. In the case of renal arteriovenous aneurysm rupture, urgent nephrectomy was the only life-saving procedure reported. The ex vivo approach seems to be an appropriate alternative to nephrectomy. This article presents a case of successful treatment of bilateral fibromuscular dysplasia with aneurysm and arteriovenous fistulas complicated by renal artery aneurysm rupture.

3D Analysis of Topographic and Anatomical Features of the Arterial and Venous Vessel Structure in Kidney

“…Our experimental morphological study is based on a 3D analysis of variants of the intra-organ division of the main branches of the renal arteries and the fusion of the main renal venous vessels. We have carried out studies to study the topographic and anatomical features of the structure of the arterial vessels of the kidneys relative to the venous vessels, since, according to some researchers, the renal veins repeat the course of the cognominal arteries [6][7][8][9][10][11][12][13][14][15][16][17][18][19], with which we cannot agree. The results of our studies revealed 17 topographic and anatomical variants of the location of the arteries relative to the venous vessels.…”

“…Recently, attempts have been made to clarify the anatomy and topography of the renal vessels using new means and methods [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Thus, some researchers confirm that the course of the intra-organ venous vessels of the kidneys largely coincides with the arterial ones.…”

“…Thus, some researchers confirm that the course of the intra-organ venous vessels of the kidneys largely coincides with the arterial ones. However, at the same time, the authors emphasize that there are more veins inside the kidney than arteries [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Many other authors argue that there are more arteries in the kidneys than there are veins.…”

“…Many other authors argue that there are more arteries in the kidneys than there are veins. This feature is of great importance when performing any surgical interventions on the kidneys [8][9][10][11][12][13][14][15][16]. At the same time, anatomical studies of some authors indicate that one of the topographic features of renal vessels, in particular their intra-organ section, is the discrepancy between the number and topography of renal arteries and veins [3,[7][8][9][10][11][12].…”

Analysis of Arterial Basins and Venous Drainage Zones in Kidneys with a Two-zone Blood Supply System

“…The physiological role of these vessels is important in maintaining trophic and drainage functions where conditions such as hypertension and congestive kidney may develop in pathology [7][8][9][10]. According to some authors, when performing surgical interventions, information about the peculiarities of the blood supply to the kidney zones, the branching of the vascular basins in the organ parenchyma is very important, and information about the venous drainage of the organ is very important as well because metastases spread through these vessels from tumor foci [11][12][13]. The literature contains conflicting information about the structural features of these arteries and veins, their intra-organ branches, and the distribution of venous vessels [13].…”