Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/1677-5449.011218
Jornal Vascular Brasileiro
Case Report

Fístula arteriovenosa renal pós-biópsia renal: relato de caso e revisão de literatura‏

Renal arteriovenous fistula after renal biopsy: a case report and literature review

Sergio Quilici Belczak; Guilherme Delicato Pedroso; Luis Felipe Atihe; Ana Beatriz Furlan Vilela; Raquel Silas Melice; Cicero Benedito Junior; Gustavo Garcia Marques

http://dx.doi.org/10.1590/1677-5449.011218 J Vasc Bras, vol.18, e20180112, 2019
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Resumo

Resumo: Fístulas arteriovenosas (FAVs) renais adquiridas são raras, correspondendo a uma conexão anômala entre o sistema arterial e o sistema venoso. As FAVs renais se dividem em três grandes grupos: idiopáticas, congênitas e adquiridas, sendo as últimas as mais comuns. Atualmente, têm incidência aumentada em decorrência do crescente número de biópsias renais. Apesar de, atualmente, o procedimento de biópsia renal ser relativamente seguro, ele carrega como complicação a formação de FAV no território vascular renal. O tratamento de FAV renal é amplamente discutido na literatura e diversas modalidades terapêuticas podem ser aplicadas. Apresentamos um caso de FAV pós-biópsia renal que foi submetida a tratamento endovascular com sucesso mediante embolização com molas.

Palavras-chave

fístula arteriovenosa, embolização terapêutica, biópsia por agulha, embolização com molas, hematúria pós-biópsia, Doppler renal

Abstract

Abstract: Acquired renal arteriovenous fistulas (AVF) are rare conditions in which an anomalous connection arises between the arterial and venous systems. Renal AVFs can be classified into three main groups: idiopathic, congenital, and acquired, the last of which are the most common. Incidence has been increasing, due to the growing number of renal biopsies. Although the renal biopsy procedure is relatively safe nowadays, one possible complication is formation of an AVF in the renal vascular territory. Treatment of renal AVF is widely discussed in the literature and a variety of treatment methods can be employed. We report a case of arteriovenous fistula after renal biopsy that was successfully treated with endovascular coil embolization.
 

Keywords

arteriovenous fistula, therapeutic embolization, needle biopsy, coil embolization, post-biopsy hematuria, renal Doppler

References

Sosa-Barrios RH, Burguera V, Rodriguez-Mendiola N, et al. Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment. BMC Nephrol. 2017;18(1):365. http://dx.doi.org/10.1186/s12882-017-0786-0. PMid:29262805.

Rezende LS, Ortiz MR, de Paula SC, Gemelli JJ, Linhares A, Carvalho JGR. Relato de caso: fístula arteriovenosa renal idiopática como causa de hipertensão renovascular e insuficiência cardíaca. J Bras Nefrol. 2002;24(2):110-4.

Cho KJ, Stanley JC. Non-neoplastic congenital and acquired renal arteriovenous malformations and fistulas. Radiology. 1978;129(2):333-43. http://dx.doi.org/10.1148/129.2.333. PMid:704845.

Maldonado JE, Sheps SG, Bernatz PE, Deweerd JH, Harrison EG Jr. Renal arteriovenous fistula: a reversible cause of hypertension and heart failure. Am J Med. 1964;37(4):499-513. http://dx.doi.org/10.1016/0002-9343(64)90064-6. PMid:14215839.

Imray TJ, Cohen AJ, Hahn L. Renal arteriovenous fistula associated with fibromuscular dysplasia. Urology. 1984;23(4):378-80. http://dx.doi.org/10.1016/0090-4295(84)90146-8. PMid:6710713.

Crotty KL, Orihuela E, Warren MM. Recent advances in the diagnosis and treatment of renal arteriovenous malformations and fistulas. J Urol. 1993;150(5 Pt 1):1355-9. http://dx.doi.org/10.1016/S0022-5347(17)35778-6. PMid:8411399.

Rezende LS, Ortiz MR, Paula SC, Gemelli JJ, Linhares A, de Carvalho JG. Idiopathic renal arteriovenous fistula causing renovascular hypertension and cardiac failure. Braz J Nephrol. 2002;24(2):110-4.

Bates MC, Almehmi A. High-output congestive heart failure successfully treated with transcatheter coil embolization of a large renal arteriovenous fistula. Catheter Cardiovasc Interv. 2004;63(3):373-6. http://dx.doi.org/10.1002/ccd.20181. PMid:15505842.

Abassi ZA, Winaver J, Hoffman A. Large A-V fistula: pathophysiological consequences and therapeutic perspectives. Curr Vasc Pharmacol. 2003;1(3):347-54. http://dx.doi.org/10.2174/1570161033476619. PMid:15320481.

Fogazzi GB, Moriggi M, Fontanella U. Spontaneous renal arteriovenous fistula as a cause of haematuria. Nephrol Dial Transplant. 1997;12(2):350-6. http://dx.doi.org/10.1093/ndt/12.2.350. PMid:9132662.

Osawa T, Watarai Y, Morita K, Kakizaki H, Nonomura K. Surgery for giant high-flow renal arteriovenous fistula: experience in one institution. BJU Int. 2006;97(4):794-8. http://dx.doi.org/10.1111/j.1464-410X.2006.06108.x. PMid:16536776.

Gopi P, Vasudevan S, Kumar A, et al. Secondary hematuria from traumatic renal artery pseudo aneurysm with arteriovenous fistula treated by successful stenting. Kerala Med J. 2017;10(1):44-8.

Sezer R, Uslu N, Akdur A, Haberal M. Biopsy-related renal allograft arteriovenous fistulas: a series of 5 cases. Transplant. 2018;102:S522. http://dx.doi.org/10.1097/01.tp.0000543359.62730.30.

McAlhany JC Jr, Black HC Jr, Hanback LD Jr, Yarbrough DR 3rd. Renal arteriovenous fistula as a cause of hypertension. Am J Surg. 1971;122(1):117-20. http://dx.doi.org/10.1016/0002-9610(71)90363-1. PMid:5091842.

Zhang Z, Yang M, Song L, Tong X, Zou Y. Endovascular treatment of renal artery aneurysms and renal arteriovenous fistulas. J Vasc Surg. 2013;57(3):765-70. http://dx.doi.org/10.1016/j.jvs.2012.09.042. PMid:23312837.

Merkus JW, Zeebregts CJ, Hoitsma AJ, van Asten WN, Koene RA, Skotnicki SH. High incidence of arteriovenous fistula after biopsy of kidney allografts. Br J Surg. 1993;80(3):310-2. http://dx.doi.org/10.1002/bjs.1800800313. PMid:8472136.

Kuklik E, Sojka M, Karska K, Szajner M. Endovascular treatment of renal arteriovenous fistula with N-Butyl Cyanoacrylate (NBCA). Pol J Radiol. 2017;82:304-6. http://dx.doi.org/10.12659/PJR.900106. PMid:28656066.

Whittier WL, Korbet SM. Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol. 2004;15(1):142-7. http://dx.doi.org/10.1097/01.ASN.0000102472.37947.14. PMid:14694166.

Saliou C, Raynaud A, Blanc F, Azencot M, Fabiani JN. Idiopathic renal arteriovenous fistula: treatment with embolization. Ann Vasc Surg. 1998;12(1):75-7. http://dx.doi.org/10.1007/s100169900119. PMid:9452001.

Grocela JA, Dretler SP. Intracorporeal lithotripsy. Instrumentation and development. Urol Clin North Am. 1997;24(1):13-23. http://dx.doi.org/10.1016/S0094-0143(05)70351-7. PMid:9048849.

Ozyer U, Harman A, Soy EHA, Aytekin C, Boyvat F, Haberal M. Endovascular management of arterial complications following renal transplant biopsy. Transplant. 2018;102:S632. http://dx.doi.org/10.1097/01.tp.0000543542.40272.a5.

Benson DA, Stockinger ZT, McSwain NE Jr. Embolization of an acute renal arteriovenous fistula following a stab wound: case report and review of the literature. Am Surg. 2005;71(1):62-5. PMid:15757060.

Aston W, Whiting R, Bultitude M, Challacombe B, Glass J, Dasgupta P. Pseudoaneurysm formation after flexible ureterorenoscopy and electrohydraulic lithotripsy. Int J Clin Pract. 2004;58(3):310-1. http://dx.doi.org/10.1111/j.1368-5031.2004.00046.x. PMid:15117102.

Schwartz MJ, Smith EB, Trost DW, Vaughan ED Jr. Renal artery embolization: clinical indications and experience from over 100 cases. BJU Int. 2007;99(4):881-6. http://dx.doi.org/10.1111/j.1464-410X.2006.06653.x. PMid:17166242.

Güneyli S, Gök M, Bozkaya H, et al. Endovascular management of iatrogenic renal arterial lesions and clinical outcomes. Diagn Interv Radiol. 2015;21(3):229-34. http://dx.doi.org/10.5152/dir.2014.14286. PMid:25835080.
 

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