Complex Arteriovenous Malformation in a Kidney with Multiple Renal Arteries: A Case Report
The abnormal communications between arteries and veins outside the capillary level are called Arteriovenous Malformation (AVM). A 25-year-old known hypertensive on irregular medications, presented with acute stroke (Computed Tomography (CT) brain revealed left putamen haemorrhage). On evaluation,...
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doaj-5a604b30e6904319943d1c6d9a96e9812021-06-12T11:13:11ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2020-12-011412PD08PD09 10.7860/JCDR/2020/46590.14328Complex Arteriovenous Malformation in a Kidney with Multiple Renal Arteries: A Case ReportJ Sanjay Prakash0T Mathisekaran1Nitesh Jain2Pritam Chatterjee3Sandeep Bafna4DNB Urology Registrar, Department of Urology, Apollo Hospital, Chennai, Tamil Nadu, India.DNB Urology Registrar, Department of Urology, Apollo Hospital, Chennai, Tamil Nadu, India.Consultant Urologist, Department of Urology, Apollo Hospital, Chennai, Tamil Nadu, India.Consultant Interventional Radiologist, Department of Radiology, Apollo Hospital, Chennai, Tamil Nadu, India.Junior Consultant Urologist, Department of Urology, Apollo Hospital, Chennai, Tamil Nadu, India.The abnormal communications between arteries and veins outside the capillary level are called Arteriovenous Malformation (AVM). A 25-year-old known hypertensive on irregular medications, presented with acute stroke (Computed Tomography (CT) brain revealed left putamen haemorrhage). On evaluation, all routine investigations were normal except for microscopic haematuria. Ultrasound (USG) KUB showed right AVM and on further evaluation with 320 slice Contrast Enhanced Computed Tomography (CECT) abdomen with angiogram and 3D reconstruction revealed right kidney supplied by three renal arteries. The second renal artery was dilated (1.1 cm diameter) and communicates directly with aneurysmally dilated right renal vein (2.9 cm diameter). Digital Subtraction Angiography (DSA) with angioembolisation was done four days’ postadmission. Large second renal artery with a direct Arteriovenous Fistula (AVF) draining into the renal vein with aneurysmal venous sacs was occluded with 16 mm, 12 mm and 10 mm coils. Complete obliteration of fistula was confirmed. Then the inferior most third renal artery was accessed and angiogram revealed RAVM with multiple feeders shunting into the venous sacs and it was occluded with 40% glue. Postoperative day one USG showed thrombosed venous aneurysmal sacs and occlusion of the arterial fistulae. He was discharged at four weeks with antihypertensive and antiseizure medications. During the follow-up there was no loss in the function of the kidney and micro or macroscopic haematuria was not detected.https://jcdr.net/articles/PDF/14328/46590_CE[Ra1]_F(SHU)_PF1(AA_OM)_PFA(SL)_PN(SL).pdfaneurysmarteriovenous fistulacirsoiddigital subtraction angiographyembolisation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
J Sanjay Prakash T Mathisekaran Nitesh Jain Pritam Chatterjee Sandeep Bafna |
spellingShingle |
J Sanjay Prakash T Mathisekaran Nitesh Jain Pritam Chatterjee Sandeep Bafna Complex Arteriovenous Malformation in a Kidney with Multiple Renal Arteries: A Case Report Journal of Clinical and Diagnostic Research aneurysm arteriovenous fistula cirsoid digital subtraction angiography embolisation |
author_facet |
J Sanjay Prakash T Mathisekaran Nitesh Jain Pritam Chatterjee Sandeep Bafna |
author_sort |
J Sanjay Prakash |
title |
Complex Arteriovenous Malformation in a Kidney with Multiple Renal Arteries: A Case Report |
title_short |
Complex Arteriovenous Malformation in a Kidney with Multiple Renal Arteries: A Case Report |
title_full |
Complex Arteriovenous Malformation in a Kidney with Multiple Renal Arteries: A Case Report |
title_fullStr |
Complex Arteriovenous Malformation in a Kidney with Multiple Renal Arteries: A Case Report |
title_full_unstemmed |
Complex Arteriovenous Malformation in a Kidney with Multiple Renal Arteries: A Case Report |
title_sort |
complex arteriovenous malformation in a kidney with multiple renal arteries: a case report |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2020-12-01 |
description |
The abnormal communications between arteries and veins outside the capillary level are called Arteriovenous Malformation (AVM). A
25-year-old known hypertensive on irregular medications, presented with acute stroke (Computed Tomography (CT) brain revealed left
putamen haemorrhage). On evaluation, all routine investigations were normal except for microscopic haematuria. Ultrasound (USG)
KUB showed right AVM and on further evaluation with 320 slice Contrast Enhanced Computed Tomography (CECT) abdomen with
angiogram and 3D reconstruction revealed right kidney supplied by three renal arteries. The second renal artery was dilated (1.1 cm
diameter) and communicates directly with aneurysmally dilated right renal vein (2.9 cm diameter). Digital Subtraction Angiography
(DSA) with angioembolisation was done four days’ postadmission. Large second renal artery with a direct Arteriovenous Fistula (AVF)
draining into the renal vein with aneurysmal venous sacs was occluded with 16 mm, 12 mm and 10 mm coils. Complete obliteration
of fistula was confirmed. Then the inferior most third renal artery was accessed and angiogram revealed RAVM with multiple feeders
shunting into the venous sacs and it was occluded with 40% glue. Postoperative day one USG showed thrombosed venous aneurysmal
sacs and occlusion of the arterial fistulae. He was discharged at four weeks with antihypertensive and antiseizure medications. During
the follow-up there was no loss in the function of the kidney and micro or macroscopic haematuria was not detected. |
topic |
aneurysm arteriovenous fistula cirsoid digital subtraction angiography embolisation |
url |
https://jcdr.net/articles/PDF/14328/46590_CE[Ra1]_F(SHU)_PF1(AA_OM)_PFA(SL)_PN(SL).pdf |
work_keys_str_mv |
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