Rita Fossaceca1, Giuseppe Guzzardi1, Paolo Cerini2, Giuseppe Parziale1, Emanuele Malatesta1, Ivan Di Gesù1, Marco Quaglia3, Alessandro Carriero1. 1. Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy. 2. Department of Diagnostic and Interventional Radiology, University of Eastern Piedmont "Amedeo Avogadro", "Maggiore della Carità" Hospital, Novara, Italy. Electronic address: cerini84@hotmail.it. 3. Departments of Clinical and Experimental Medicine, Nephrology and Transplantation and International Research Centre Autoimmune Diseases (IRCAD) of the Amedeo Avogadro University, Maggiore Hospital, Novara, Italy.
Abstract
BACKGROUND: We sought to evaluate the best therapeutic management of postbiopsy arteriovenous fistulas (AVFs) in transplanted kidneys. METHODS: Between January 2005 and December 2011, we observed 17 cases of postbiopsy AVF in transplanted kidneys (9 asymptomatic; 8 symptomatic). Asymptomatic cases were managed conservatively, while patients with symptomatic AVF underwent endovascular treatment. We used a technique that consisted in a superselective transcatheter embolization of the afferent branch. We evaluated the technical success (postoperative closure of AVF), the immediate clinical efficacy (cessation of symptoms), and clinical efficacy at follow-up (measurement of serum creatinine at 7 days and 6 and 12 months compared with preoperative levels using t-tests). RESULTS: Asymptomatic AVFs resolved spontaneously, while the endovascular treatment in symptomatic AVFs showed a complete technical and clinical success with prompt remission of the presented symptoms. We observed a statistically significant reduction in serum creatinine at 7 days and 6 and 12 months postoperatively (mean creatinine--preoperative: 3.23 ± 1.4 mg/dL; 7 days: 2.25 ± 0.8 mg/dL; 6 months: 1.65 ± 0.28 mg/dL; 12 months: 1.4 ± 0.26 mg/dL; in all cases P < 0.05). CONCLUSIONS: In our experience, asymptomatic AVFs could be managed conservatively with close follow-up while the endovascular treatment for symptomatic AVFs is both safe and effective in the short- and long-term.
BACKGROUND: We sought to evaluate the best therapeutic management of postbiopsy arteriovenous fistulas (AVFs) in transplanted kidneys. METHODS: Between January 2005 and December 2011, we observed 17 cases of postbiopsy AVF in transplanted kidneys (9 asymptomatic; 8 symptomatic). Asymptomatic cases were managed conservatively, while patients with symptomatic AVF underwent endovascular treatment. We used a technique that consisted in a superselective transcatheter embolization of the afferent branch. We evaluated the technical success (postoperative closure of AVF), the immediate clinical efficacy (cessation of symptoms), and clinical efficacy at follow-up (measurement of serum creatinine at 7 days and 6 and 12 months compared with preoperative levels using t-tests). RESULTS: Asymptomatic AVFs resolved spontaneously, while the endovascular treatment in symptomatic AVFs showed a complete technical and clinical success with prompt remission of the presented symptoms. We observed a statistically significant reduction in serum creatinine at 7 days and 6 and 12 months postoperatively (mean creatinine--preoperative: 3.23 ± 1.4 mg/dL; 7 days: 2.25 ± 0.8 mg/dL; 6 months: 1.65 ± 0.28 mg/dL; 12 months: 1.4 ± 0.26 mg/dL; in all cases P < 0.05). CONCLUSIONS: In our experience, asymptomatic AVFs could be managed conservatively with close follow-up while the endovascular treatment for symptomatic AVFs is both safe and effective in the short- and long-term.
Authors: Arkadiusz Lubas; Anna Wojtecka; Jerzy Smoszna; Piotr Koziński; Emilia Frankowska; Stanisław Niemczyk Journal: Int Urol Nephrol Date: 2016-08-31 Impact factor: 2.370
Authors: Lina M Serna-Higuita; Monica Zuluaga-Quintero; Jose M Hidalgo-Oviedo; Sergio Alvarez Vallejo; Arbey Aristizabal-Alzate; Gustavo A Zuluaga-Valencia; John F Nieto-Ríos Journal: Indian J Nephrol Date: 2021-04-02