Intraoperative balloon catheter control of renal arteriovenous fistula

Renal arteriovenous fistulas have been managed with embolic therapy or surgical excision. In the case of a large, hemodynamically significant shunt sudden occlusion of the renal artery may result in profound circulatory decompensation. We managed such a case with a combined approach. An intra-arteri...

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Bibliographic Details
Published in:	The Journal of urology Vol. 132; no. 2; p. 326
Main Authors:	Sullivan, L D, Goldenberg, S L
Format:	Journal Article
Language:	English
Published:	United States 01-08-1984
Subjects:	Aged Arteriovenous Fistula - diagnostic imaging Arteriovenous Fistula - surgery Arteriovenous Fistula - therapy Embolization, Therapeutic Humans Male Nephrectomy Radiography Renal Artery - diagnostic imaging Renal Veins - diagnostic imaging
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Summary:	Renal arteriovenous fistulas have been managed with embolic therapy or surgical excision. In the case of a large, hemodynamically significant shunt sudden occlusion of the renal artery may result in profound circulatory decompensation. We managed such a case with a combined approach. An intra-arterial balloon catheter was inserted into the renal artery under fluoroscopic guidance, with constant monitoring of the central cardiac indexes via a Swan-Ganz line. The balloon was inflated and then released as circulatory changes were corrected. Once the patient was stable we performed a simple nephrectomy. We recommend this combined, controlled approach for the management of large arteriovenous fistulas.
ISSN:	0022-5347
DOI:	10.1016/S0022-5347(17)49612-1