巨大腎動静脈瘻の術中破裂の1例；排血路側のballoon閉塞時のpit fall

抄録

A male in his seventy’s had been incidentally diagnosed with a large arteriovenous malformation (AVM) of the right kidney of the high-flow type. We tried to embolize this large aneurysmal type AVM by arterial and venous occlusion with dual balloon catheters. However, the patient developed a shock state immediately after inflation of the dual balloon catheters. CT immediately after this event showed massive hemorrhage in the perirenal space. TAE using detachable coils and N-butyl cyanoacrylate with Lipiodol was used rapidly and the patient recovered.
The intraprocedural rupture might be caused by a sudden arterial flow into the aneurysm blocked the outflow by the balloon via the venous approach due to the migration of the inflated balloon via arterial approach.
We discussed about the treatment strategy of the large aneurysmal type AVM of the Kidney.