Triple-coaxial Balloon-occluded n-butyl Cyanoacrylate Embolization for a Renal Arteriovenous Fistula: A Case Report

Renal arteriovenous fistula is a rare vascular lesion. We report a man in his 40s with a right renal arteriovenous fistula consisting of a single feeding artery, a single draining vein, and a venous aneurysmal component with outflow stenosis, corresponding to a type I lesion in the Cho/Yakes-based angio-architectural classification. To achieve occlusion extending from the shunt point toward the venous aneurysmal component while preserving the surrounding renal parenchyma, balloon-occluded embolization with warmed 33% n-butyl-2-cyanoacrylate using a triple-coaxial system was performed, followed by proximal coil reinforcement. The shunt disappeared completely without renal dysfunction or procedure-related complications. This case suggests that triple-coaxial balloon-occluded n-butyl-2-cyanoacrylate embolization may be a useful option for selected renal arteriovenous fistulas.