Non-neoplastic congenital and acquired renal arteriovenous malformations and fistulas

Abnormal renal arteriovenous communications were documented by renal angiography in 21 patients. Included were congenital malformations, traumatic fistulas and spontaneous fistulas associated with renal arterial disease. Each type exhibited characteristic angiographic features. Overt clinical manifestations were observed in more than half the cases. Specific treatment depended upon type, location and size of the arteriovenous communication. Small, covert renal fistulas and malformations were managed conservatively. Five medium size symptomatic intrarenal arteriovenous fistulas and one malformation were successfully treated by transcatheter embolization. Large lesions, especially when associated with renal arterial disease, may be more appropriately treated by surgery.