Presentation and treatment of arteriovenous fistula, arteriovenous malformation, and pseudoaneurysm of the kidney in Ramathibodi Hospital
Keywords:
Renal arteriovenous fistula, renal arteriovenous malformation, renal pseudoaneurysm, embolizationAbstract
Objective: To review the presentation, predisposing factors, treatment and outcome of renal vascular malformation, including arteriovenous malformation AVM), arteriovenous fistula (AVF) and pseudoaneurysm of the kidney in Ramathibodi Hospital.
Material and Method: In-patient medical records from January 2007 to January 2017 were retrospectively reviewed. Patients admitted and diagnosed with any type of vascular malformation of the kidney, comprising AVM, AVF and pseudoaneurysm in Ramathibodi Hospital were included in the study. Baseline characteristics of the patients, including gender, age at diagnosis, and underlying disease were recorded. Vascular malformation, clinical presentation, imaging data, predisposing factors of the disease, treatment and the outcome of patients were summarized and reported.
Results: Seventeen patients were diagnosed with vascular malformation; 9 patients were males and 8 females. The most common comorbidity was hypertension, followed by chronic kidney disease. Nine patients had AVF (52.94%), 3 had AVM (17.65%), 2 had pseudoaneurysm (11.76%), and 3 had AVF with pseudoaneurysm (17.65%). Common presentations were gross hematuria, flank pain, anemia, and hypovolemic shock. Previous surgery and history of renal biopsy were mutual predisposing factors. Embolization was the most common treatment option. All patients were asymptomatic on follow-up visit with a median follow-up of 90 days.
Conclusion: Vascular malformation of the kidney is not a common condition. The history of previous kidney surgery and renal biopsy may help for diagnostic
suspicion. Renal embolization was the proper management with a high success rate.
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