Congenital renal arteriovenous fistula during the first trimester diagnosed with ultrasonography

J Med Ultrason (2001). 2017 Jan;44(1):141-145. doi: 10.1007/s10396-016-0719-8. Epub 2016 Sep 9.

Abstract

A case of congenital renal arteriovenous fistula (AVF) complicating pregnancy with gross hematuria was managed successfully by superselective embolization with metallic coils. The patient was in the first trimester of her pregnancy at 12 weeks of gestation. The AVF was detected by color Doppler sonography and confirmed by renal arteriography. Because of its easy accessibility and absence of irradiation, ultrasound is the first choice for pregnant patients. Color Doppler ultrasound is effective in diagnosing AVF, and it is also helpful in the long-term followup after treatment. The cirsoid-type renal congenital arteriovenous fistula has a characteristic sonographic appearance with a cluster of tubular anechoic structures in the kidney, which produce continuous turbulent high-velocity flow signals and a burr-like boundary flow spectrum. When the sonographic features are present, the diagnosis of renal AVF should be made, after which renal arteriography can be performed to confirm it. Selective embolization provided a safe and effective treatment with minimal damage to the parenchyma and without compromising renal function.

Keywords: Arteriovenous fistula; Congenital; Embolization; Pregnancy; Renal artery; Ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arteriovenous Fistula / diagnostic imaging*
  • Arteriovenous Fistula / therapy*
  • Diagnosis, Differential
  • Embolization, Therapeutic
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnostic imaging*
  • Pregnancy Complications, Cardiovascular / therapy*
  • Renal Artery / abnormalities
  • Renal Artery / diagnostic imaging
  • Renal Veins / abnormalities
  • Renal Veins / diagnostic imaging
  • Ultrasonography, Doppler, Color* / methods
  • Ultrasonography, Prenatal* / methods