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Transarterial embolization of a large high-flow right renal arteriovenous fistula using stents and an across-stent wire-trapping technique  Ren-Fu Shie,

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Presentation on theme: "Transarterial embolization of a large high-flow right renal arteriovenous fistula using stents and an across-stent wire-trapping technique  Ren-Fu Shie,"— Presentation transcript:

1 Transarterial embolization of a large high-flow right renal arteriovenous fistula using stents and an across-stent wire-trapping technique  Ren-Fu Shie, MD, Ta-Wei Su, MD, Ming-Yi Hsu, MD, Sung-Yu Chu, MD, Po-Jen Ko, MD  Journal of Vascular Surgery Cases and Innovative Techniques  Volume 5, Issue 2, Pages (June 2019) DOI: /j.jvscit Copyright © 2019 The Authors Terms and Conditions

2 Fig 1 Coronal computed tomography angiography image showing a large tortuous right renal arteriovenous fistula (AVF; arrow) with engorged inferior vena cava. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, DOI: ( /j.jvscit ) Copyright © 2019 The Authors Terms and Conditions

3 Fig 2 Aortogram showing a large tortuous right renal arteriovenous fistula (AVF; arrow) with early opacification of inferior vena cava, indicating high flow. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, DOI: ( /j.jvscit ) Copyright © 2019 The Authors Terms and Conditions

4 Fig 3 A, Right renal angiogram showing status after deployment of a bare-metal stent in the renal arteriovenous fistula (AVF), with a total of three catheters, including a VER catheter (arrow) for in-stent coil deployment and two Progreat microcatheters (arrowheads) for out-stent coil deployment. B, Contrast medium filling in the stent, indicating a inch metallic coil out-in-out of the stent as a barrier (arrowhead) and a inch metallic coil in the stent (arrow) trapped by the inch coil. C, Multiple inch metallic coils deployed in the stent and inch metallic coils deployed outside the stent in the renal AVF, blocked by bare-metal stent without migration. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, DOI: ( /j.jvscit ) Copyright © 2019 The Authors Terms and Conditions

5 Fig 4 A, Final angiography. B, Follow-up computed tomography angiography showing complete occlusion of the arteriovenous fistula (AVF). Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, DOI: ( /j.jvscit ) Copyright © 2019 The Authors Terms and Conditions

6 Fig 5 Step-by-step illustration of the wire-trapping technique. The red area indicates feeding branch of renal artery, and the blue area indicates drainage vein. A, Two preplaced microcatheters (dark blue thin catheters) from guiding catheter. B, Relationship of bare-metal stent and catheters, including two preplaced microcatheters and central VER catheter (central midsized catheter). C, Third microcatheter advanced from the VER catheter, through opposite sides of stent mesh. A inch coil was deployed from this catheter and left in the path. D, After deployment of two inch coils as in-stent barriers. E, Deployment of inch coils in stent, entangled with in-stent barriers. F, Deployment of inch coils outside the stent to fill the gap between stent and vessel. d-f, Demonstration of cross-sectional view corresponding to D-F. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, DOI: ( /j.jvscit ) Copyright © 2019 The Authors Terms and Conditions

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