Journal: Interventional Radiology
Article Title: Successful Hybrid Treatment of Transcatheter Renal Artery Embolization and Open Ligation of Left Renal Vein for Renal Arterial-venous Malformation with Huge Venous Sac: A Case Report
doi: 10.22575/interventionalradiology.2024-0005
Figure Lengend Snippet: a. b: Five years ago; At the time of treatment for symptomatic right rAVM. a. Pretreatment right renal artery angiography shows a cirsoid type of rAVM. b. After embolization with NBCA and microcoils, right renal angiography confirms the disappearance of rAVM and normal renal branches, resulting in the right renal dysfunction. c. After embolization of the right rAVM, the 99mTc-MAG3 scintigraphy reveals that the right kidney was barely functioning (purple line: right, blue line: left). d, e. Contrast-enhanced CT (d: axial, e: coronal) shows a left venous sac up to 9.1 cm (black dotted line) of the left rAVM and a dilated IVC of 4 cm in diameter (blue dotted line). f. In the dorsal view of the 3D reconstructed image of CT, the left renal artery is bifurcated into the dorsal and ventral branches. This 3D image shows that the dorsal branch (white arrow) is involved in the rAVM, although it is difficult to identify arteriovenous shunting point. rAVM: renal arteriovenous malformation; NBCA: N-butyl-2-cyanoacrylate; IVC: inferior vena cava; 3D: three-dimensional
Article Snippet: After confirming that the dorsal branch of the left renal artery was the feeding artery for rAVM , the branch was embolized with a 14 mm × 8 mm vascular plug (Amplatzer Vascular Plug, Abbott, Chicago, IL, USA) followed by coil embolization (AZUR CX18 12 mm × 38 cm × 2, Terumo, Tokyo, Japan, Target XXL 12 mm × 45 cm, 10 mm × 40 cm × 2, 8 mm × 20 cm, Stryker, Kalamazoo, MI, USA) using microcatheter (Carry 2 marker 2.3/2.9 Fr, UTM, Toyohashi, Japan) inside the plug.
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