We report the use of a 4 mm vascular Amplatzer for the occlusion of a renal arterovenous fistula between the renal artery, at the hylum trifurcation point, and an aneurismatic vein draining into the main renal vein, where there was no possibility to use any other device from the venous side, because of the diameter and the high flow, neither from the arterious side without sacrificing lobar branches. The device was implanted at the exact point of communication, like a patent foramen ovale occluder, with the distal disc into the artery lumen and the other two proximal discs into the venous side. A 34-years-old Caucasian woman suffered several episodes of paroxysmal supraventricular tachycardia associated with dyspnoea, after the onset of post-pregnancy hypertension. She underwent CTA, spectral Doppler sonography and angiography which showed a renal arteriovenous fistula (RAVF) between the renal artery, at the hylum trifurcation point, and an extremely ectatic vein draining into the main renal vein of the right kidney. With both arterial and venous access, the RAVF was selectively embolized using a 4 × 6 mm Amplatzer Vascular Plug II, released into the communication between artery and vein ensuring the patency of vessels involved. The RAVF was almost completely excluded and the hemodynamic effects associated were also corrected. The use of this device, though in an alternative way, allowed the exclusion of the high flow A-V fistula without sacrificing any parent renal vessel and preserving the renal function.

中文翻译：

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4 mm Amplatzer血管栓塞II在治疗肾动静脉瘘中的应用：一例病例报告

我们报告了使用4 mm血管Amplatzer封堵在肾动脉，肺门分叉点处的肾动静脉瘘，以及向主肾静脉引流的无大动脉的静脉，无法使用其他任何装置由于直径大和流量大，所以从静脉侧从静脉侧开始，都没有从大动脉侧开始而不牺牲大叶分支。该装置被植入精确的连通点，如卵圆孔未闭封堵器，远端盘进入动脉内腔，另外两个近端盘进入静脉侧。一名34岁的白人妇女在妊娠后高血压发作后遭受阵发性阵发性室上性心动过速并伴有呼吸困难。她接受了CTA，频谱多普勒超声检查和血管造影显示，在肾门的三叉形分叉点和极右的主干静脉向右主肾静脉引流之间存在肾动静脉瘘（RAVF）。既有动脉通路又有静脉通路，RAVF用4×6 mm Amplatzer血管塞II选择性栓塞，释放到动脉和静脉之间的连通处，确保所涉血管的通畅。几乎完全排除了RAVF，并且还纠正了相关的血液动力学效应。尽管以另一种方式使用该装置，但可以在不牺牲任何母体肾血管和保持肾功能的情况下排除高流量AV瘘。一条极宽的静脉流入右肾的主肾静脉。既有动脉通路又有静脉通路，RAVF用4×6 mm Amplatzer血管塞II选择性栓塞，释放到动脉和静脉之间的连通处，确保所涉血管的通畅。几乎完全排除了RAVF，并且还纠正了相关的血液动力学效应。尽管以另一种方式使用该装置，但可以在不牺牲任何母体肾血管和保持肾功能的情况下排除高流量AV瘘。一条极宽的静脉流入右肾的主肾静脉。既有动脉通路又有静脉通路，RAVF用4×6 mm Amplatzer血管塞II选择性栓塞，释放到动脉和静脉之间的连通处，确保所涉血管的通畅。几乎完全排除了RAVF，并且还纠正了相关的血液动力学效应。尽管以另一种方式使用该装置，但可以在不牺牲任何母体肾血管和保持肾功能的情况下排除高流量AV瘘。几乎完全排除了RAVF，并且还纠正了相关的血液动力学效应。尽管以另一种方式使用该装置，但可以在不牺牲任何母体肾血管和保持肾功能的情况下排除高流量AV瘘。几乎完全排除了RAVF，并且还纠正了相关的血液动力学效应。尽管以另一种方式使用该装置，但可以在不牺牲任何母体肾血管和保持肾功能的情况下排除高流量AV瘘。