Surgery for giant high-flow renal arteriovenous fistula: experience in one institution

BJU International
Takahiro OsawaKatsuya Nonomura

Abstract

To present five cases of renal arteriovenous fistula (RAVF) seen at our institution, with an emphasis on surgical treatment. We assessed five patients with giant high-flow RAVF. The affected kidney was evaluated functionally using (99m)Tc-diethylenetriamine pentaacetic acid renal scintigraphy. The size, location, involvement of branched arteries, and renal function dictated the choice of operative method. Four patients were treated with in situ ligation of the feeding artery for extrarenal RAVF, and the remaining patient had a nephrectomy of the nonfunctioning kidney. The clinical outcome was analysed by renal function, blood pressure control, radiographic cardiothoracic ratio (CTR), occlusion of RAVF, and renal artery patency. Of two patients with hypertension, the blood pressure was normalized in one. The renal function of the affected side was preserved in four patients. CTR was normalized or improved in all four patients with preoperative cardiomegaly. There was no recurrence of RAVF in any of the five patients and there was no major morbidity after surgery. Surgery for giant high-flow RAVF is safe and feasible from the perspective of complications and recurrence, even though transarterial embolization has become the first ...Continue Reading

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Citations

May 23, 2014·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·José Fernando Val-BernalJosé L Gutierrez-Baños
Jul 31, 2013·Annals of Vascular Surgery·Hideaki ObaraYuko Kitagawa
Mar 1, 2012·Journal of Vascular and Interventional Radiology : JVIR·Jeremy C DurackRobert K Kerlan
May 15, 2007·Journal of Vascular and Interventional Radiology : JVIR·Oluwatoyin IdowuScott O Trerotola
Jun 9, 2015·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Vijaywant BrarUmberto Campia
Dec 14, 2011·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Nitin GargPeter Gloviczki
Jul 3, 2008·Vascular Medicine·Jagjeeth NaikJonathan R Boyle
Mar 24, 2010·Vascular and Endovascular Surgery·Craig R GrebenEric Gandras
Jul 2, 2019·Jornal Vascular Brasileiro·Sergio Quilici BelczakGustavo Garcia Marques

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