Large renal arteriovenous fistula treated by embolization: 2 case reports

Renal arteriovenous fistula (RAVF) is an infrequent vascular anomaly characterized by an aberrant connection between the renal artery and vein, potentially leading to significant clinical consequences. This condition may be congenital, acquired, or idiopathic and can manifest with symptoms such as hypertension, cardiac strain, renal impairment, or hematuria. Diagnostic imaging, including digital subtraction angiography (DSA) as the definitive standard, alongside noninvasive modalities like Doppler ultrasound and computed tomography (CT), plays a critical role in identifying and planning treatment for RAVF. While large fistulas have historically necessitated nephrectomy, endovascular embolization offers a minimally invasive alternative to mitigate hemodynamic complications and preserve renal function. This report details 2 cases of substantial RAVF treated successfully with endovascular techniques, demonstrating their efficacy as a primary intervention for complex fistulas, thereby reducing the need for surgical approaches.