Imaging Pearls ❯ Kidney ❯ AVMs
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- “Congenital renal arteriovenous malformations (AVMs) are abnormal communications between the intrarenal venous and arterial system. Such anomalies in the renal vasculature are rare causes of gross hematuria. A significant number of patients with renal AVMs are hypertensive, and its clinical presentation is variable, ranging from incidental finding in an asymptomatic patient to congestive cardiac failure due to high output from a giant AVM. Its classical presentation is that of gross hematuria, occasionally associated with the passage of blood clots and flank pain.”
Congenital renal arteriovenous malformation presenting with gross hematuria after a routine jog: a case report
Erin L Dames et al.
Journal of Medical Case Reports 2014, 8:65 - “Renal AVM can be idiopathic, congenital or acquired, and are usually differentiated by their angiographic configuration. Acquired renal AVM (more frequently referred to as arteriovenous fistulas) are the most common type (up to 75% of all cases), frequently due to iatrogenic trauma such as renal biopsy or surgery. Other causes include blunt or penetrating trauma, pyelonephritis and renal cell carcinoma. Such cases are characterized in imaging studies as a solitary communication between an artery and a vein. Congenital renal AVM make up about 25% of all cases, and usually present in the third to fourth decade of life.”
Congenital renal arteriovenous malformation presenting with gross hematuria after a routine jog: a case report
Erin L Dames et al.
Journal of Medical Case Reports 2014, 8:65
- “ Congenital renal arteriovenous malformations (AVMs) are abnormal communications between the intrarenal venous and arterial system. Such anomalies in the renal vasculature are rare causes of gross hematuria. A significant number of patients with renal AVMs are hypertensive, and its clinical presentation is variable, ranging from incidental finding in an asymptomatic patient to congestive cardiac failure due to high output from a giant AVM. Its classical presentation is that of gross hematuria, occasionally associated with the passage of blood clots and flank pain.”
Congenital renal arteriovenous malformation presenting with gross hematuria after a routine jog: a case report
Erin L Dames et al.
Journal of Medical Case Reports 2014, 8:65 - “Renal AVM can be idiopathic, congenital or acquired, and are usually differentiated by their angiographic configuration. Acquired renal AVM (more frequently referred to as arteriovenous fistulas) are the most common type (up to 75% of all cases), frequently due to iatrogenic trauma such as renal biopsy or surgery. Other causes include blunt or penetrating trauma, pyelonephritis and renal cell carcinoma. Such cases are characterized in imaging studies as a solitary communication between an artery and a vein. Congenital renal AVM make up about 25% of all cases, and usually present in the third to fourth decade of life.”
Congenital renal arteriovenous malformation presenting with gross hematuria after a routine jog: a case report
Erin L Dames et al.
Journal of Medical Case Reports 2014, 8:65 - “Minimally invasive percutaneous transarterial embolization therapy is the first line in the treatment of renal AVM. Embolization can be performed using different materials such as glue, the Onyx® liquid embolic system, alcohol, gelatin sponges and foams, and PVA particles. Disadvantages of embolization therapy include the risk of nephropathy secondary to the contrast used during radiographic evaluation as well as the possible need for repeat sessions.
Surgical treatment of renal AVM is reserved for cases of large cirsoid malformations, cases intractable to medical and/or endovascular therapy and cases related to malignancy; there have been documented cases of renal AVM requiring urgent nephrectomy.”
Congenital renal arteriovenous malformation presenting with gross hematuria after a routine jog: a case report
Erin L Dames et al.
Journal of Medical Case Reports 2014, 8:65
- “ Renal arteriovenous malformations (AVMs) are rare lesions and may be acquired or congenital. Acquired renal AVMs (arteriovenous fistulas [AVFs]) are relatively rare, accounting for 3% to 5% of all renal AVMs. Hematuria is the major and most common symptom; other clinical manifestations, such as hypertension, left ventricular hypertrophy, cardiac failure, and abdominal pain are also usually associated with AVMs.”
Gross hematuria caused by a congenital intrarenal arteriovenous malformation: a case report
Carrafiello G et al.
J Med Case Reports 2011;5: 510 - “Congenital renal arteriovenous fistulas are the most uncommon form, but their incidence may be underestimated because patients are usually asymptomatic.”
Gross hematuria caused by a congenital intrarenal arteriovenous malformation: a case report
Carrafiello G et al.
J Med Case Reports 2011;5: 510 - “Congenital AVMs are uncommon and Color Doppler ultrasonography, MSCT, angiography, and DSA are the most important tools for making the diagnosis in an urgent setting. The therapeutic decision must be made by considering the general condition of the patient and his or her symptoms. The only therapy considered in the past was nephrectomy, but embolization by selective catheterization can be considered safe and effective. However, many studies need to be done to confirm the role of embolization.”
Gross hematuria caused by a congenital intrarenal arteriovenous malformation: a case report
Carrafiello G et al.
J Med Case Reports 2011;5: 510 - CTA Evaluation of the Renal Arteries: Aneurysms
- Variable in size
- Single to multiple in number
- May be partially or totally calcified
- May be a result of atherosclerosis, IVDA, vasculitis