Endovascular embolization strategy for renal arteriovenous malformations

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Nephrology

Background:

• Renal arteriovenous malformations (AVMs) are rare vascular anomalies causing hematuria.
• Treatment has shifted from open nephrectomy to less invasive transcatheter arterial embolization (TAE).

Purpose of the Study:

• To retrospectively evaluate the efficacy and safety of TAE for treating renal AVMs.
• To compare outcomes based on different embolization materials used.

Main Methods:

• Retrospective analysis of 12 patients with renal AVMs and gross hematuria.
• 14 TAE sessions using liquid agents, gelatin sponge, or coils.
• Assessment of technical success, clinical success, and complications, with follow-up of 7-92 months.

Main Results:

• Technical success was achieved in all patients.
• Primary clinical success was observed in all patients, with recurrence in two patients treated with coils alone.
• Combination therapy (coils with other agents or liquid agents) showed significantly better clinical success (P=0.045) than coils alone.
• No major complications, post-embolization syndrome, or renal function deterioration were noted.

Conclusions:

• TAE is a safe and effective treatment for renal AVMs.
• Outcomes are favorable, with recurrence being a possibility when coils are used exclusively.
• Combination embolization strategies enhance treatment efficacy.