Korean J Urol.  2009 Aug;50(8):816-818. 10.4111/kju.2009.50.8.816.

Newly Discovered Pseudoaneurysm after Embolization of a Renal Arteriovenous Fistula with a Pseudoaneurysm following a Renal Stab Wound

• Choi SB
• Kim MK
• Jeong YB
• Park JK
• Kim HJ
• Kim YG

• KMID: 1780488
• DOI: http://doi.org/10.4111/kju.2009.50.8.816

Abstract

Post-traumatic arteriovenous fistula (AVF) and pseudoaneurysm are rare, and mostly occur in stab wound patients. Suspected AVF and pseudoaneurysm requires angiography, with planned simultaneous embolization. Superselective embolization is generally a safe and effective treatment modality for AVF and pseudoaneurysm with minimal associated morbidity. Rare complications of the embolization do occur, including renal abscess, postembolization syndrome, impaired renal function, pulmonary embolism caused by migration of coils, and allergic reaction. We present here the case of a man who presented with a newly discovered pseudoaneurysm after embolization of a renal AVF with pseudoaneurysm after a renal stab wound.

Keyword

Arteriovenous fistula; False aneurysm; Therapeutic embolization

MeSH Terms

Abscess
Aneurysm, False
Angiography
Arteriovenous Fistula
Embolization, Therapeutic
Humans
Hypersensitivity
Pulmonary Embolism
Wounds, Stab

Figure

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  Fig. 1 (A) Computed tomography with contrast in the arterial phase shows bright enhancement in the central portion of the right kidney, suspicious of a pseudoaneurysm. (B) Angiography shows a 2.5×2.0 cm sized pseudoaneurysm (black arrow) in the posterior branch of the lower pole of renal artery and early visualization of the renal veins (white arrow) during the arterial phase of the study due to arteriovenous fistula. Angiography after superselective coil embolization of the pseudoaneurysm and arteriovenous fistula.

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  Fig. 2 (A) The embolization coil is visible around the right pelvis and a 9 mm sized pseudoaneurysm is observed. (B) The pseudoaneurysm is visible in the interlobar artery branch of the mid-artery, and embolization was performed after superselection of vessels. Devascularization of the pseudoaneurysm was observed.

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