Abstract:

Introduction: renal arteriovenous malformation (AVM) is a pathological communication between renal arteries and veins, both acquired and congenital. Congenital AVMs of kidneys, on average, remain asymptomatic for up to 30-40 years, occurring mainly in women, may manifest with hematuria and pain. Nephrectomy is known to be historical method of treating AVM of the kidney, however, with the development of angiographic instrumentation, endovascular methods of treatment began to be introduced into practice more often.

Case report: a 30-year-old female patient with ongoing recurrent bleeding from the urogenital tract. Performed preoperative examination: laboratory tests, cystoscopy, ultrasound, multispiral computed tomography. Patient underwent angiography followed by embolization of kidney AVM with Squid.

Results: intraoperatively, it was noted that AVM embolization is partial. During the first day of the observation period, the presence of postembolization syndrome in the form of hyperthermia, pain and dysuric syndromes, a phenomenon of systemic reaction according to laboratory tests were noted. After 1,5 months, patient was hospitalized for second stage of embolizaion, but during angiography it appeared, that AVM is totally embolized.

Conclusions: renal artery embolization in patients with renal arteriovenous malformations is a minimally invasive, effective method of treatment.

1. The process of selective embolization is controlled and can be used as an independent method of treatment.

2. Due to selective catheterization of arteries and the infusion of agent directly into the affected area, segmental infarction occurs, as a result of which there is minimal destruction of the healthy part of the kidney parenchyma, the function of the kidney will not suffer.

References

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Abstract:

Arteriovenous malformation (AVM) of kidney - is rarely seen vascular anomaly, with clinical polymorphism (hematuria, hypertension, left ventricular hypertrophy, heart failure, abdominal pain), and difficult diagnostic algorithms and is often a cause for radical organ-resecting operations (nephrectomy).

Article describes a case report of 37 years old patient with a diagnosis of «arteriovenous malformation of left renal artery», and the clinical picture of hematuria, post-hemorrhagic anemia. Patient underwent ultrasound of kidneys and bladder (no disease found) and multi-slice computed tomography (AVM of upper pole of left kidney, sized 5,4x5,0 cm).

Patient underwent endovascular embolization of AVM with 4 coils «Flipper». Patients was discharged on the 7th day without complications after the control ultrasound and MSCT The use of selective endovascular embolization of renal AVM reduces or removes clinical manifestations, and has lower operational risks, as well as allows you to save the function of the intact portion of renal parenchyma, which don't lead to patient's disability (in comparison with to organ-resecting surgery).

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