Flow-arrest interventional repair of renal allograft arteriovenous fistula and pseudoaneurysms

Jason Salsamendi, Ami Vakharia, Adam N. Checkver, Govindarajan Narayanan, Eric Peterson

Research output: Contribution to journalArticle

Abstract

As core biopsies of transplanted kidneys remain the gold standard for diagnosis of rejection, the risk of iatrogenic complications such as arteriovenous fistulas (AVF) and pseudoaneurysms remains quite real. This case report describes a case of a 59-year-old female with a suspected occult post-biopsy AVF and pseudoaneurysm which over 6 years became enlarged and multilobulated, discovered on routine follow-up imaging. As the patient was symptomatic with flash pulmonary edema, intervention was planned. Angiography demonstrated a complex network of pseudoaneurysms with high flow drainage to the renal venous system. As initial attempts at coil embolization failed due to high flow velocities, a proximal and distal balloon occlusion technique was implemented along with a combination of coils (Axium; Covidien) and glue (Trufil; DePuy) to obtain lasting resolution of the patient's pathology with minimal risk of embolization material flowing distally. The authors theorize that this technique will facilitate similar results in various high-flow situations, as with transplant AV fistulas.

Original languageEnglish (US)
Pages (from-to)E67-E72
JournalVascular Disease Management
Volume11
Issue number3
StatePublished - Mar 2014

Keywords

  • arteriovenous fistula
  • flow dynamics
  • new techniques
  • pseudoaneurysm
  • renal artery intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Salsamendi, J., Vakharia, A., Checkver, A. N., Narayanan, G., & Peterson, E. (2014). Flow-arrest interventional repair of renal allograft arteriovenous fistula and pseudoaneurysms. Vascular Disease Management, 11(3), E67-E72.