PMC3546418_01
A 36 mm aneurysm (arrowhead) of the residual right renal artery combined with a giant AVF (arrow) between the right renal artery and the inferior vena cava was diagnosed by computed tomography. Note the increased opacity of the inferior vena cava during the arterial phase due to torrential flow from the artery to the vein.
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F1
The aortogram confirmed the large aneurysm (arrow) of the right renal pedicle.
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F2
Catheter (Cordis, Bridgewater, NJ, USA). Contrast agent: Imeron 300, Bracco, Konstanz, Germany) confirmed an aneurysm of the distal right residual renal artery and a giant AVF between the aneurysm and the inferior vena cava (Figure 2 (Fig. 2)). 
Selective angiography of the residual right renal artery demonstrates the giant AVF to the truncated renal vein (arrow) and inferior vena cava, which is visualized by contrast agent.
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F3
Again, antegrade right renal arteriography demonstrated an aneurysmatic and tortuous residual right renal artery with torrential flow from the renal artery to the inferior vena cava via the residual renal vein (Figure 3 (Fig. 3)). 
Through-and-through, i.e. arteriovenous guide wire access via the right common femoral artery and the right common femoral vein
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F4
The venous segment of the AVF was occluded by deployment of an AVP IV, 7 mm. The radiopaque markings of the AVP are clearly visible (arrows). Note that the fistula is completely sealed by the occluder, the inflow into the aneurysm of the renal artery (upstream of the AVP) is overprojected with the AVP.
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F5
Paul, MN, USA) was deployed within the venous segment of the AVF and completely occluded the fistula (Figure 5 (Fig. 5)).
The final aortogram revealed successful embolization of the AVF and exclusion of the aneurysm. Contours and radiopaque markings of the AVP II, 16 mm (arrow) and the AVP IV, 7 mm (arrowhead) are clearly visible.
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F6
The final aortogram revealed successful embolization of both, the AVF and the right renal artery (Figure 6 (Fig. 6)).