Subscribe to RSS
DOI: 10.1055/s-0039-1694094
Complex Renal Arteriovenous Malformation (AVM) Embolization using Ethylene Vinyl Alcohol (EVOH) Copolymer and a Balloon Microcatheter
Publication History
Received: 24 April 2019
Accepted after revision: 27 May 2019
Publication Date:
25 July 2019 (online)
Abstract
Occurrence of a symptomatic renal arteriovenous malformation (AVM) is rare. The authors present the case of a patient with a background of Turner's syndrome, hemophilia B, and horseshoe kidney, who presented with hematuria and was successfully treated with endovascular embolization. The use of a microballoon catheter Scepter XC (Microvention, Inc.) to safely embolize the feeding arterial supply, using ethylene vinyl alcohol (EVOH) copolymer (Onyx; Medtronic/ev3) has not, to the authors’ knowledge, previously been described for the treatment of renal AVM. This novel use of an occlusal balloon catheter is permitted by the precipitation rate of Onyx, and allowed a safe and effective procedure, reducing the risk of reflux, allowing a forward push of embolic material in a controlled manner.
-
References
- 1 Carvalho AB, Guerra JúniorG, Baptista MT, de Faria AP, Marini SH, Guerra AT. Cardiovascular and renal anomalies in Turner's syndrome. Rev Assoc Med Bras (1992) 2010; 56 (06) 655-659
- 2 Cho SK, Do YS, Shin SW. et al. Arteriovenous malformations of the body and extremities: analysis of therapeutic outcomes and approaches according to a modified angiographic classification. J Endovasc Ther 2006; 13 (04) 527-538
- 3 Juan YH, Lin YC, Sheng TW. et al. Application of onyx for renal arteriovenous malformation with first case report of a renal hyperdense striation sign: a CARE-compliant article. Medicine (Baltimore) 2015; 94 (39) e1658
- 4 Wetter A, Schlunz-Hendann M, Meila D, Rohde D, Brassel F. Endovascular treatment of a renal arteriovenous malformation with Onyx. Cardiovasc Intervent Radiol 2012; 35 (01) 211-214
- 5 Maruno M, Kiyosue H, Tanoue S. et al. Renal arteriovenous shunts: clinical features, imaging appearance, and transcatheter embolization based on angioarchitecture. Radiographics 2016; 36 (02) 580-595
- 6 Kimura Y, Osuga K, Ono Y, Nakazawa T, Higashihara H, Tomiyama N. Long-term outcomes of selective renal artery embolization for renal arteriovenous fistulae with dilated venous sac. J Vasc Interv Radiol 2018; 29 (07) 952-957
- 7 McConnell KA, Tjoumakaris SI, Allen J. et al. Neuroendovascular management of dural arteriovenous malformations. Neurosurg Clin N Am 2009; 20 (04) 431-439
- 8 Kang F, Shah K, Park H. et al. 3:18 PM Abstract No. 103 Balloon-assisted Onyx embolization of high-flow peripheral arteriovenous malformations with dual-lumen coaxial balloon microcatheter: technical aspects and clinical results. J Vasc Interv Radiol 2018; 29 (04) S48