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Successful surgical treatment with ex vivo technique in a patient with renal artery aneurysm rupture and bilateral arteriovenous fistula  Alexander Ivandaev,

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Presentation on theme: "Successful surgical treatment with ex vivo technique in a patient with renal artery aneurysm rupture and bilateral arteriovenous fistula  Alexander Ivandaev,"— Presentation transcript:

1 Successful surgical treatment with ex vivo technique in a patient with renal artery aneurysm rupture and bilateral arteriovenous fistula  Alexander Ivandaev, MD, Ainur Askerova, MD, Andrey Zotikov, PhD, Anzhelika Kozhanova, MD, Wolfgang Schima, MD, MSc, Grigory Karmazanovsky, PhD  Journal of Vascular Surgery Cases and Innovative Techniques  Volume 4, Issue 3, Pages (September 2018) DOI: /j.jvscit Copyright © 2018 The Author(s) Terms and Conditions

2 Fig 1 Computed tomography (CT) angiography of bilateral arteriovenous fistula (AVF). a and b, Axial images and (c) the volume-rendered image show aneurysmal dilatation of both renal arteries and veins with early contrast enhancement of the renal veins and inferior vena cava. d, The coronal reformation reveals the left lower pole renal artery (1) and the left upper pole renal artery (2). Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, DOI: ( /j.jvscit ) Copyright © 2018 The Author(s) Terms and Conditions

3 Fig 2 Angiographic and intraoperative images of the right renal arteriovenous fistula (AVF). a, Selective right renal angiogram shows the “string of beads” sign (1) of fibromuscular dysplasia (FMD) and the arteriovenous shunt (2). b, Right renal digital subtraction angiography image after transarterial embolization. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, DOI: ( /j.jvscit ) Copyright © 2018 The Author(s) Terms and Conditions

4 Fig 3 Digital subtraction angiography, computed tomography (CT), and intraoperative images of the left renal arteriovenous fistula (AVF). Left renal angiogram before (a) and after (b) coil embolization shows occlusion of fistula. c, CT angiography (coronal reformation) shows a perinephric hematoma. d, Intraoperative picture. The left kidney is placed in the tray with ice cubes. The tip of forceps inserted in the ruptured renal aneurysm. (e) Intraoperative image. The oversewn orifices of feeding and draining arteries with patches (arrows). Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, DOI: ( /j.jvscit ) Copyright © 2018 The Author(s) Terms and Conditions

5 Fig 4 Computed tomography (CT) at 9-months follow-up. a, Volume rendering image demonstrates the optimal surgical result after repair: the stump of the left upper-pole renal artery (1), reimplanted left upper pole renal artery (2); coil (3); and occluder (4). b, Renal parenchyma of both kidneys shows normal enhancement, there is only a small scar in the middle third of the left kidney. Journal of Vascular Surgery Cases and Innovative Techniques 2018 4, DOI: ( /j.jvscit ) Copyright © 2018 The Author(s) Terms and Conditions

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