A case of multi-plug flow control technique treating high flow cirsoid renal arteriovenous malformations

Renal arteriovenous malformations (AVMs) are rare vascular lesions mostly diagnosed when they become symptomatic. These lesions can be treated using a variety of endovascular techniques and devices.

We present a 51-year-old male who presented with acute onset right flank pain, hematuria and refractory hypertension. The patient was treated using a multi-plug flow control technique using multiple balloon catheters and microcatheters. Two operators worked synchronously during the procedure using two different dilutions of glue. The patient's symptoms resolved immediately after the embolization and at 1 month follow up the CT demonstrated complete obliteration of the AVM with little renal parenchymal loss. The patient remained clinically asymptomatic at the 6-months follow-up.

This case illustrates the feasibility and safety use of synchronous embolization in the treatment of complex renal AVMs.