Therapeutic embolization of idiopathic renal arteriovenous fistula using the "Stop-Flow" technique

Purpose: To present a case of massive idiopathic arteriovenous fistula (AVF ) successfully treated with an endovascular procedure. Case Report: A 42-year-old woman with microscopic hematuria was found to ha ve a massive idiopathic renal AVF. Percutaneous embolization was undertaken using a dual approach to deliver an occluding balloon through the draining vein and an arterial access to selectively catheterize the aneurysmal affe rent artery. With the balloon inflated to interrupt flow ("stop-flow" techn ique), acrylic glue was delivered precisely to occlude the lesion. Duplex s cans at 12 months have documented continued complete occlusion of the anoma lous communication. Conclusions: The dual arterial and venous approach with the "stop-flow" tec hnique makes it possible to successfully treat idiopathic AVFs that have co nstant high-flow connections.