case_images: PMC9352472_01
case_images: PMC9352472_02
case_images: In the superior pole there is a focal area of marked increased flow (arrow) with disorganized echoes cyst suggesting an arteriovenous fistula.
case_images: CRIT2022-5274521.001.jpg
case_images: PMC9352472_02_CRIT2022-5274521.001.jpg
case_images: fig1
case_images: A bedside ultrasound of the transplanted kidney was done, which showed no hydronephrosis and no perinephric fluid collections, but the color-Doppler sonography in the superior pole showed a focal area of marked increased flow with disorganized audible echo cluster suggesting an arteriovenous fistula (Figure 1), giving the history of allograft renal biopsy.
case_images: Radionuclide angiogram demonstrates normal blood flow to the right lower quadrant transplant. Subsequent renogram images demonstrate cortical retention of radiopharmaceutical without definite excretion with rising renogram curve, suggestive of ATN.
case_images: CRIT2022-5274521.002.jpg
case_images: PMC9352472_02_CRIT2022-5274521.002.jpg
case_images: fig2
case_images: At this time, we did a radionuclide angiogram scan was done and showed normal blood flow to the transplanted kidney with cortical retention of radiopharmaceutical without definite excretion with rising renogram curve, which is suggestive of acute tubular necrosis (Figure 2).
case_images: Interpolar region segmental renal artery (arrow): a small focus of early arterial filling was noted with associated early venous drainage demonstrating AVF.
case_images: CRIT2022-5274521.003.jpg
case_images: PMC9352472_02_CRIT2022-5274521.003.jpg
case_images: fig3
case_images: IR hoping to control the AVF with the minimum graft function damage using superselective transcatheter embolization. In IR, a segmental interpolar renal artery in the upper pole suggesting the arteriovenous fistula location was successfully selected, embolized, and resolved the fistula (Figures 3 and 4).
case_images: Postembolization arteriogram demonstrates resolution of the venous drainage area.
case_images: CRIT2022-5274521.004.jpg
case_images: PMC9352472_02_CRIT2022-5274521.004.jpg
case_images: fig4
case_images: IR hoping to control the AVF with the minimum graft function damage using superselective transcatheter embolization. In IR, a segmental interpolar renal artery in the upper pole suggesting the arteriovenous fistula location was successfully selected, embolized, and resolved the fistula (Figures 3 and 4).