Endovascular embolization of idiopathic renal arteriovenous fistula – A case report and literature review

Abstract

Idiopathic renal arteriovenous fistulas (RAVFs) are rare vascular anomalies with no identifiable etiology. We present a case of 65-year-female who was being evaluated for complaints of the right flank pain and dysuria with no past history of trauma or surgery. Computed tomography showed arteriovenous fistula in lower pole of the right kidney with dilated branch of the right renal artery and dilated venous sacs. The patient was planned for endovascular embolization. Right renal angiogram showed dilated lower polar artery with a single-hole arteriovenous fistula. Selective coil embolization of the arterial channel was done. Post-deployment angiogram showed complete occlusion of the fistula and normal opacification of remaining segmental branches. On follow-up 1-month later, the patient was in good general condition. With advancements in endovascular techniques, transcatheter embolization has become initial treatment of choice for managing RAVF due to its less incidence for complications and preservation of renal function.