Endovascular Treatment of Renal Arteriovenous Fistula with N-Butyl Cyanoacrylate (NBCA)

BACKGROUND: Renal arteriovenous malformation (RAVM) is a rare disease. The causes of pathological connections between renal arteries may be congenital or iatrogenic – mainly as a consequence of a biopsy or due to renal carcinomas and postinflammatory changes. Computed tomography, ultrasound Doppler and angiography are the main diagnostic tools used for the detection of RAVMs. CASE REPORT: The aim of this study is to present a case of endovascular treatment of RAVM with a mixture of NBCA and lipiodol. A 29-year-old woman was suffering from drug-resistant hypertension secondary to RAVM. The malformation was embolized using NBCA mixed with lipiodol. The postoperative course was uneventful. A follow-up angio-CT, performed 3 months and one year after the procedure, showed a complete occlusion of the RAVM. CONCLUSIONS: NBCA can be used alone to embolize RAVMs. Procedures involving a combination of NBCA and lipiodol are difficult and should be performed by experienced specialists.