腎動静脈瘻の保存的治療について

Abstract

Three cases of renal arteriovenous fistula which were treated in an attempt to preserve the kidney were reported. The first case was arteriovenous fistula which occurred after percutaneous renal biopsy. It was confirmed that the fistula had spontaneously disappeared on the 114th day after the biopsy in the course of the rest. The second patient who had two cirsoid type arteriovenous fistulae in the right kidney was treated by transcatheteral supers elective embolization of the feeding artery. A complete cure was obtained. The third case was also cirsoid type arteriovenous fistula. It was suggested that two segmental arteries were related to the fistula by intraoperative arteriograms. One of them was obviously feeding the fistula but the other was obscure at that time, therefore only the former was ligated with regard to the residual function of the kidney. Since then hematuria could be controled but the fistula fed from the latter was confirmed to have remained on the postoperative arteriograms. We reviewed the literatures of conservative treatment of arteriovenous fistula and emphasized excellence of transcatheteral superselective embolization as a therapeutic method for the fistulae which are multiple or fed from multiple segmental arteries without surgical exploration of the kidney.