Embolization of Giant Post-Traumatic Arteriovenous Renal Fistula using the Penumbra Occlusion Device

Abstract

Purpose: Giant post-traumatic artero-venous renal fistula is a very rare condition, and the exclusion of renal perfusion is the principal risk of embolization. Aim of our presentation is to evaluate new materials and devices derivated by neuro-angio experience to treat the vascular arterio-venous renal fistula. Material and Methods: From march 2017t to december 2020 we have treated 3 post traumatic hight-flow artero-venous renal fistulas. In one case an aneurysmatic dilatation of renal artery was associated. All patients were previously and during follow-up evaluated by MDCTA and US-color-Doppler. POD Penumbra System plus, POD packing coil were used to treat arterio-venous renal fistula. Results: In all cases (3/3) complete arterio-venous renal fistula occlusion was obtained. Pod System and Pod packing coil were delivered with microcatheter directly in the arterial side of the arterio-venous renal fistula. The renal fuction and complete parenchymal preservation were obtained Conclusions: In our preliminary experience Penumbra System revealed to be a secure device for a complete exclusion of high-flow arterio-venous renal fistula and preserving renal perfusion.