We present the case of a 51 year-old-white male with a giant right ren
al arteriovenous fistula secondary to a carcinoma. Neither the aorta n
or the kidneys were visualized after the injection of 60 mL of contras
t media into the abdominal aorta. Moreover, the right kidney could not
be visualized after 30 mL of contrast media were injected selectively
into the right renal artery. This was due to a great arteriovenous sh
unt through the right kidney. The right renal angiogram was obtained t
hrough digital imaging, after injecting contrast media into the right
renal artery, previously occluded by a balloon-catheter, The image of
an hypervascularized nephroma was obtained, depicting an important art
eriovenous shunt of the of contrast material toward the inferior vena
cava from a fistula located in the right inferior renal pole. The occl
usion of the right renal artery was partially achieved by injecting 40
mL of boiling contrast media, followed by small fragments of Gelfoam
suspended in the contrast substance. The balloon-catheter remained inf
lated in the right renal artery until a nephrectomy was performed. As
far as we know, a case in which the aorta and renal circulation are un
able to be seen by means of conventional angiography, because of the p
resence of a renal arteriovenous shunt to the fistula, has not been de
scribed.