PMC5343253_01
(a) The right renal vein was enhanced in the early phase. (b) There are multiple tortuous vessels around the right renal hilus (white arrow), part of which invaded into the renal parenchyma and renal calix (black arrow).
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fig1
CT was performed after consulting with a respiratory disease expert. CT revealed the early enhancement of the right renal vein (Figure 1(a)) and multiple tortuous vessels around the right renal hilus, part of which had invaded into the renal parenchyma and renal calix (Figure 1(b)).
(a) Angiographic image obtained prior to embolization. Abnormal tortuous vessels (nidus) arise from the right renal artery (arrow heads). Early enhancement of inferior vena cava can be seen (arrow). (b) Embolization of abnormal vessels is performed from the ovarian artery using 0.8 cc of n-butyl-2-cyanoacylate (NBCA) lipiodol under arterial flow control by occlusion balloon (arrow). (c) Abnormal vessels from the renal lower segmental branch are embolized using a gelatin sponge and metallic coils. Extravasation to collecting system can be seen (arrow). (d) Extravasation to collecting system from the renal upper segmental branch (arrow). (e) Postembolization angiography. Minor abnormal vessels remain (arrow).
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fig2
There were abnormal vessels arising from the right renal artery (Figure 2(a)). Embolization of the abnormal vessels from the ovarian artery was performed using 0.8 cc of n-butyl-2-cyanoacylate (NBCA) lipiodol (NBCA : lipiodol = 1 : 4) under arterial flow control by occlusion balloon (Figure 2(b)). Extravasation via abnormal vessels from the renal lower segmental branch was resolved using a gelatin sponge and metallic coils (Figure 2(c)). Although there were no apparent abnormal vessels, extravasation from the renal upper segmental branch was found, which was embolized with a gelatin sponge (Figure 2(d)). Minor abnormal vessels remained (Figure 2(e)).