Life-Threatening Hematuria from an Arteriovenous Fistula Complicating an Open Renal Biopsy

Arteriovenous fistulae and pseudoaneurysms are not rare after renal biopsy. The majority of these lesions (80%) are asymptomatic or show only transient symptoms. We present here a patient who developed life-threatening hematuria following an open renal biopsy. Arteriovenous fistula and pseudoaneurysm were detected in the biopsied kidney by color-coded Doppler sonography, confirmed by angiography, and the fistula was sealed by superselective arterial embolization with metallic coils. Color-coded Doppler sonography successfully detects the majority of arteriovenous fistulae after renal biopsy, and selective arterial embolization obviates the need for surgical intervention in most cases.

[1]  R. Peces,et al.  Symptomatic intrarenal arteriovenous fistula detected 25 years after percutaneous renal biopsy. , 1996, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[2]  K. L. Harrison,et al.  Renal dysfunction due to an arteriovenous fistula in a transplant recipient. , 1994, Journal of the American Society of Nephrology : JASN.

[3]  D. Roccatello,et al.  Nephrology Dialysis Transplantation Colour-coded Doppler sonography in monitoring native kidney biopsies , 2004 .

[4]  K. Tung,et al.  Renal biopsy in diffuse renal disease--experience with a 14-gauge automated biopsy gun. , 1992, Clinical radiology.

[5]  S. Renowden,et al.  Duplex and colour flow sonography in the diagnosis of post-biopsy arteriovenous fistulae in the transplant kidney. , 1992, Clinical radiology.

[6]  A. W. Reid,et al.  Renal artery aneurysm 6 years after percutaneous renal biopsy: successful treatment by embolization. , 1992, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[7]  P. Corr,et al.  Embolization in traumatic intrarenal vascular injuries. , 1991, Clinical radiology.

[8]  G. Boner,et al.  A successful treatment of an intrarenal arteriovenous fistula by percutaneous embolization. , 1991, JAMA.

[9]  F. Karnel,et al.  Renal allograft arteriovenous fistula due to needle biopsy with late onset of symptoms--diagnosis and treatment. , 1991, Nephron.

[10]  P. Walker Stab wounds of the renal artery branches: angiographic diagnosis and treatment by embolization: Fisher RG, Ben-Menachem Y, Whigham C. AJR 1989; 152:1231–1235 , 1990 .

[11]  Y. Ben-menachem,et al.  Stab wounds of the renal artery branches: angiographic diagnosis and treatment by embolization. , 1989, AJR. American journal of roentgenology.

[12]  R. Raja,et al.  Selective embolization of vascular complications following renal biopsy of the transplant kidney. , 1985, Transplantation Proceedings.

[13]  F. Keller,et al.  Percutaneous vaso-occlusion for nonmalignant renal lesions. , 1983, The Journal of urology.

[14]  T. Golper,et al.  Complications of percutaneous needle biopsy of the kidney. , 1982, American journal of nephrology.

[15]  C. Linke,et al.  Percutaneous kidney biopsies. Complications and their management. , 1981, Urology.

[16]  J. Bauer,et al.  Selective renal artery embolization for control of biopsy-induced bleeding. , 1981, Southern medical journal.

[17]  J. Díaz-Buxó,et al.  Control of post renal biopsy hemorrhage by Gelfoam embolization. , 1981, Nephron.

[18]  F. Marshall,et al.  Treatment of traumatic renal arteriovenous fistulas by detachable silicone balloon embolization. , 1979, The Journal of urology.

[19]  C. E. Carlton,et al.  Iatrogenic renal vascular injury. , 1978, Urology.

[20]  E. Vaughan,et al.  A comparative study of open surgical and percutaneous renal biopsies. , 1977, The Journal of urology.

[21]  Diaz-Buxo Ja,et al.  Complications of percutaneous renal biopsy: an analysis of 1,000 consecutive biopsies. , 1975, Clinical nephrology.

[22]  W. Foley,et al.  Control of renal hemorrhage by selective arterial embolization. , 1975, The American journal of roentgenology, radium therapy, and nuclear medicine.

[23]  S. Fellner,et al.  Transcatheter embolization of renal arteriovenous fistula. , 1975, Urology.

[24]  S. Silber,et al.  Treatment of massive hemorrhage after renal biopsy with angiographic injection of clot. , 1975, The New England journal of medicine.

[25]  J. Díaz-Buxó,et al.  Complications of percutaneous renal biopsy: an analysis of 1,000 consecutive biopsies. , 1975, Clinical nephrology.

[26]  H. Goldstein,et al.  Successful management of postbiopsy arteriovenous fistula with selective arterial embolization. , 1973, Radiology.

[27]  L. Ekelund,et al.  Arteriovenous Fistulae following Percutaneous Renal Biopsy , 1971, Acta radiologica: diagnosis.

[28]  A. Remmers,et al.  Intrarenal Arteriovenous Fistula and Systemic Hypertension Following Percutaneous Renal Biopsy , 1968 .

[29]  G. H. Smith,et al.  Intrarenal arteriovenous fistula and systemic hypertension following precutaneous renal biopsy. Report of a case. , 1968, Nephron.

[30]  S. N. Wiener,et al.  Intrarenal arteriovenous fistula and aneurysm. A complication of percutaneous renal biopsy. , 1965, The American journal of roentgenology, radium therapy, and nuclear medicine.