A successful treatment of an intrarenal arteriovenous fistula by percutaneous embolization
Article Abstract:
An arteriovenous fistula (AV) is an abnormal connection between an artery and a vein, which is most often inherited, but may occur as the result of trauma, expansion of the wall of a blood vessel, or cancer. Sometimes the cause is unknown. Among the complications of an AV are high blood pressure (hypertension), congestive heart failure, continuous abnormal sounds in the abdomen or lower back (bruits), and blood in the urine (hematuria). When fistulas occur in the kidney (intrarenal), they are often caused by kidney biopsy. The case of a 37-year-old woman with poorly controlled hypertension is described. At age 18 she had undergone tests, including kidney biopsy, because of high blood pressure and partial facial paralysis. Upon admission at age 37, various heart and circulatory abnormalities were present, and a large AV fistula was found in the right kidney. By diverting normal blood flow, fistulas reduce blood to the rest of the kidney. Although treatment once involved removal of the affected kidney, this condition is now treated by blocking the abnormal flow (embolization), as was done in this case. The X-ray suggests that the fistula was caused by the biopsy performed almost 20 years before, although there is a possibility that it was congenital. Most patients who develop fistulas after biopsy already suffered from hypertension, and the probability of a hypertensive patient developing a fistula is almost one in five. In this case, the patient felt well after embolization of the fistula, and antihypertensive treatment was discontinued. Three months later blood pressure was normal, even though hypertension had been present for over two decades. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Treatment of funguria
Article Abstract:
Amphotericin B bladder irrigation appears to be the most effective treatment for uncomplicated funguria - fungal infection in the urine that produces few symptoms - and oral ketoconazole appears to be the least effective. All of the studies published between 1960 and 1991 that evaluated treatments for funguria were reviewed. None of the studies included a control group - patients with funguria who were not treated - and many used different criteria to measure the treatment's effectiveness. Studies of patients who are not treated for funguria have found that many patients' infections resolve spontaneously. In addition, certain conditions predispose an individual to develop funguria, and when these conditions are removed, the infection may resolve. Urinary catheterization has been associated with persistent funguria, which resolves when the catheter is removed.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
User Contributions:
Comment about this article or add new information about this topic: