Late evolution of an arteriovenous fistula in renal transplant: a case report

Intrarenal arteriovenous fistula (AVF) formation is a well-known complication of percutaneous needle biopsy, a procedure frequently performed following renal transplantation. Persisting AVFs are rare and most often formed within the first weeks to months following the provoking invasive procedure.

We present a case of a 66-year-old male transplant recipient with an intrarenal AVF which was discovered more than a decade after renal transplant and after the last invasive procedure was performed. The AVF become evolutive only another 6.5 years later, initially resulting in uncontrolled arterial hypertension, later followed by acute kidney injury. Transcatheter coil embolization was performed, leading to improvement in arterial hypertension and recovery of renal function to baseline levels.

Intrarenal AVFs can become evolutive and symptomatic long after the provoking procedure. Transcatheter coil embolization was technically and clinically successful.