Selective angiography and therapeutic embolization of renal arteriovenous fistula (report of 20 cases)

Objective To investigate angiographic manifestations and interventional treatment of renal arteriovenous fistulas. Methods Renal arterial angiographies were performed in 20 patients from multiple hospitals.These patients suffered from repeatedly intermittent hematuria,but ultrasound,KUB,IVU,CT and endoscopy could not contribute to the diagnosis.The angiographic manifestations and treating procedure were analyzed. Results All the 20 cases were diagnosed as renal arteriovenous fistula by means of angiography.According to the image manifestations,these cases were classified into three types:(1)deformed branches and shunt in 11 cases;(2)high discharge shunt without deformed banches in 4;(3)concealed shunt showed by superselective segmental artery angiography but negative by renal artery angiography in 5.All fistulas of the 20 cases were successfully embolized with different materials including gelfoam,sodium morrhuate,ethanol,PVA,TH-glue,coils,etc. Conclusions Superselective renal angiography and embolization are the most important and effective tools for diagnosis and treatment of renal arteriovenous fistula.