Renal Artery Aneurysm and Arteriovenous Fistula Associated with Fibromuscular Dysplasia: Successful Treatment with Detachable Coils Roi Altit, BS, Daniel.

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Renal Artery Aneurysm and Arteriovenous Fistula Associated with Fibromuscular Dysplasia: Successful Treatment with Detachable Coils Roi Altit, BS, Daniel B. Brown, MD, Geoffrey A. Gardiner, MD Journal of Vascular and Interventional Radiology Volume 20, Issue 8, Pages 1083-1086 (August 2009) DOI: 10.1016/j.jvir.2009.04.066 Copyright © 2009 SIR Terms and Conditions

Figure 1 (a) Selective right renal angiogram demonstrates beading of the main artery, which is diagnostic of FMD. A multilobulated aneurysm (black arrowheads) communicates directly (arrow) with a markedly enlarged renal venous branch (white arrowhead). (b) Selection of the main right renal artery distal to the aneurysm reveals the normal appearance of the other vessels. Journal of Vascular and Interventional Radiology 2009 20, 1083-1086DOI: (10.1016/j.jvir.2009.04.066) Copyright © 2009 SIR Terms and Conditions

Figure 2 (a) Spot image obtained after placement of a framing coil. This coil allowed the other detachable coils to form a nest, with a decrease in the risk of inadvertent migration. (b) Angiogram obtained at the end of the first procedure after deployment of multiple detachable coils. Persistent filling of the aneurysm and AVF is present, which prompted further evaluation with computed tomographic angiography. Journal of Vascular and Interventional Radiology 2009 20, 1083-1086DOI: (10.1016/j.jvir.2009.04.066) Copyright © 2009 SIR Terms and Conditions

Figure 3 (a) Arteriogram via the microcatheter at the second embolization session demonstrates catheterization of the second aneurysm component to the level of the AVF communication. (b) Final angiogram demonstrates no further flow through the aneurysm. There is persistent contrast medium in the venous component of the AVF secondary to the lack of inflow. Journal of Vascular and Interventional Radiology 2009 20, 1083-1086DOI: (10.1016/j.jvir.2009.04.066) Copyright © 2009 SIR Terms and Conditions

Figure 4 Doppler US scan obtained after embolization demonstrates the absence of flow in the AVF. (Available in color online at www.jvir.org.) Journal of Vascular and Interventional Radiology 2009 20, 1083-1086DOI: (10.1016/j.jvir.2009.04.066) Copyright © 2009 SIR Terms and Conditions