Successful Hybrid Treatment of Transcatheter Renal Artery Embolization and Open Ligation of Left Renal Vein for Renal Arterial-venous Malformation with Huge Venous Sac: A Case Report

Abstract

Although transcatheter arterial embolization is the first choice treatment for renal arteriovenous malformation. Renal arteriovenous malformation with dilated venous sac can cause venous pulmonary thromboembolism after transcatheter arterial embolization. A woman in her 60s was diagnosed with a left renal arteriovenous malformation and an 8 cm venous sac with renal dysfunction after right renal arteriovenous malformation treatment. We performed a hybrid treatment of transcatheter arterial embolization and sequential vein ligation to reduce the risk of lethal thrombotic complications. After treatment, the left renal arteriovenous malformation disappeared without fatal complications, and the venous sac shrunk with the preservation of renal function as it was before the hybrid treatment. When performing embolization of renal arteriovenous malformation with a huge venous sac, hybrid treatment of arterial embolization and surgical vein ligation may be safe and useful for preventing fatal post-operative thrombotic complications.