Use of a Partially Deployed Wallstent to Act as an Inferior Vena Cava Filtration Device during Coil Embolization of a High-flow Arteriovenous Fistula

Abstract

Closure of high-flow arteriovenous (AV) fistulas with endovascular coil embolization can be technically challenging and fraught with complication as a result of the possibility of coil migration into venous circulation and subsequent embolization to distant sites such as the heart and lungs. Filtration of the AV fistula's central venous outflow may allow trapping of coils that inadvertently pass into the venous system during the procedure. This useful measure can reduce the morbidity associated with such interventions. The present report describes an unusual case of a large high-flow renal AV fistula embolized with the use of a partially deployed Wallstent as a temporary filtration device within an enlarged suprarenal inferior vena cava. This method further allows removal of any trapped coils without the need for a snare device.