PMC5366758_01
Admission CT-scan showing complex vascular intraparenchymal renal anomaly.
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Diagnostic work-up was completed with computed tomography of the abdomen (Figure 1) which confirmed a complex vascular anomaly with a huge left renal artery.
Digital subtracted angiography at early arterial phase showing an hypertrophic aneurysmal left renal artery. White arrow points to a aneurysmal dilatation at the level of the arteriovenous fistula corresponding to the interposition of a chronic pseudoaneurysm between the upper segmental artery and the draining vein.
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At the arterial phase, the enlarged interlobular artery directly drains through the arteriovenous fistula into a first cyst-like cavity (20 mm) corresponding to a chronic arterial pseudoaneurysm (Figure 2).
Digital subtracted angiography at the venous phase showing multiple dilatations of the draining renal veins, especially one huge venous dilatation (white arrow) with interposition of a normal segment before drainage into the left renal vein.
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At the venous phase a huge venous dilation is seen (54 x 37 mm), subsequently draining into a smaller venous dilatation and from there into the main renal vein (Figure 3).
Control angiogram after embolization.
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Interlock-35 (Boston Scientifics) 12 x 40. Immediate and complete occlusion was shown by the control angiogram (Figure 4).