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首页> 美国卫生研究院文献>GMS German Medical Science >Transcatheter Amplatzer vascular plug-embolization of a giant postnephrectomy arteriovenous fistula combined with an aneurysm of the renal pedicle by through-and-through arteriovenous access
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Transcatheter Amplatzer vascular plug-embolization of a giant postnephrectomy arteriovenous fistula combined with an aneurysm of the renal pedicle by through-and-through arteriovenous access

机译：穿刺穿刺动静脉通路结合巨大的肾切除术后动静脉瘘经导管Amplatzer血管栓塞术并结合肾蒂动脉瘤

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Although endovascular transcatheter embolization of arteriovenous fistulas is minimally invasive, the torrential flow prevailing within a fistula implies the risk of migration of the deployed embolization devices into the downstream venous and pulmonary circulation. We present the endovascular treatment of a giant postnephrectomy arteriovenous fistula between the right renal pedicle and the residual renal vein in a 63-year-old man.The purpose of this case report is to demonstrate that the Amplatzer vascular plug (AVP) can be safely positioned to embolize even relatively large arteriovenous fistulas (AVFs). Secondly, we illustrate that this occluder can even be introduced to the fistula via a transvenous catheter in cases where it is initially not possible to advance the deployment-catheter through a tortuous feeder artery. Migration of the vascular plug was ruled out at follow-up 4 months subsequently to the intervention.Thus, the Amplatzer vascular plug and the arteriovenous through-and-through guide wire access with subsequent transvenous deployment should be considered in similar cases.
机译：尽管动静脉瘘的血管内导管栓塞是微创的，但在瘘管中盛行的洪流暗示了已部署的栓塞装置迁移到下游静脉和肺循环的风险。我们介绍了一名63岁男性右肾蒂与残余肾静脉之间巨大的肾切除术后动静脉瘘的腔内治疗方法。本病例报告的目的是证明Amplatzer血管塞（AVP）可以安全甚至可以栓塞相对较大的动静脉瘘（AVF）。其次，我们说明，在最初不可能通过弯曲的支线动脉推进部署导管的情况下，甚至可以通过静脉导管将该封堵器引入瘘管。干预后4个月的随访中排除了血管栓塞的迁移，因此，在类似情况下，应考虑使用Amplatzer血管栓塞和动静脉穿刺导丝并随后进行静脉部署。

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