Surgery has traditionally been the definitive form of invasive management for renal vascular injuries. There is a growing trend in the use of endovascular techniques as an alternative to surgery in the trauma setting. We present the case of a 24-year-old woman with an acute renal arteriovenous fistula caused by a stab wound in the left flank, which was successfully managed with selective arterial embolization. This represents only the second reported case of such an approach in the acute setting.
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References
1.
ReillyK.J., ShapiroM.B., HaskalZ.J.Angiographic embolization of a penetrating traumatic renal arteriovenous fistula.J Trauma1996; 41: 763–5.
2.
HeynsC.F., Van VollenhovenP.Increasing role of angiography and segmental artery embolization in the management of renal stab wounds.J Urol1992; 147: 1231–4.
KhanA.B., ReidA.W.Management of renal stab wounds by arteriographic embolisation.Scand J Urol Nephrol1994; 28: 109–10.
5.
CakmakM., CakmakN., ArikanE.Congestive heart failure due to traumatic arteriovenous fistula—two case reports.Angiology2003; 54: 625–9.
6.
KavicS.M., AtwehN., IvyM.E.Renal artery to inferior vena cava fistula following gunshot wound to the abdomen.Ann Vasc Surg2002; 16: 666–70.
7.
TillouA., RomeroJ., AsensioJ.A.Renal vascular injuries.Surg Clin North Am2001; 81: 1417–30.
8.
FerradaR., BiroliniD.New concepts in the management of patients with penetrating abdominal wounds.Surg Clin North Am1999; 79: 1331–56.
9.
WeissV.J., ChaikofE.L.Endovascular treatment of vascular injuries.Surg Clin North Am1999; 79: 653–65.
10.
HeynsC.F., Van VollenhovenP.Selective surgical management of renal stab wounds.Br J Urol1992; 69: 351–7.
11.
FisherR.G., Ben-MenachemY., WhighamC.Stab wounds of the renal artery branches: angiographic diagnosis and treatment by embolization.Am J Roentgenol1989; 152: 1231–5.
12.
KnudsonM.M., MaullK.I.Nonoperative management of solid organ injuries: past, present, and future.Surg Clin North Am1999; 79: 1357–71.
13.
BooksteinJ.J., GoldsteinH.M.Successful management of postbiopsy arteriovenous fistula and selective arterial embolization.Radiology1973; 109: 535.
14.
DinkelH.P.Blunt renal trauma: minimally invasive management with microcatheter embolization experience in nine patients.Radiology2002; 223: 723–30.
15.
PetersonN.E.Fate of functionless post-traumatic renal segment.Urology1986; 27: 237–42.
16.
HornD., EileyD., LumermanJ.H.Complete renal embolization as an alternative to nephrectomy.J Urol1999; 161: 24–7.