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Войти в исследования Clinical radiology · 2026
Endovascular management of arteriovenous fistula postbiopsy of pediatric transplanted kidney using embolization with detachable coils.
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McDonnell C, de Oliveira V R, Teoh C W, Dien Esquivel M F, McKay A, Gasparetto A, Parra D A
Аннотация
AIM: Ultrasound (US)-guided transplant kidney biopsy is required to exclude rejection or other causes of allograft dysfunction. Arteriovenous fistula (AVF) is a known complication, with occurrence rates from 1.5% to 18%. AVF may heal spontaneously; however, persistent lesions may result in hypertension, renal impairment, or hematuria. The purpose of the present study was to investigate the technical details and outcomes of postbiopsy kidney transplant AVF in children, treated by interventional radiology.
MATERIALS AND METHODS: This was a retrospective review (2019-2026) of renal transplant AVF embolization procedures in a pediatric tertiary care center. Clinical details, including transplant history, biopsy, AVF diagnosis, embolization procedural details, and postembolization clinical course, were collected. Technical success was defined as occlusion of the lesion with cessation of early venous filling, and improved flow to the adjacent parenchyma.
RESULTS: Four cases were identified, with a mean age of 15 years 1 month. Embolization was indicated due to long-term persistence and increasing lesion size on serial imaging. US and computed tomography (CT) were used for procedural planning. In all cases, a femoral arterial access approach was used, with a combination of two detachable coils (anchoring and packing), obtaining AVF occlusion. A 100% technical success rate was achieved. This has persisted in postprocedure imaging follow-up (mean follow-up: 17 months [2-36]). No minor or major adverse events were observed.
CONCLUSION: This study illustrates that embolization with detachable coils is a viable option to treat postbiopsy kidney transplant AVF in children. An anchoring and packing coil combination was feasible and effective in this small cohort.
MATERIALS AND METHODS: This was a retrospective review (2019-2026) of renal transplant AVF embolization procedures in a pediatric tertiary care center. Clinical details, including transplant history, biopsy, AVF diagnosis, embolization procedural details, and postembolization clinical course, were collected. Technical success was defined as occlusion of the lesion with cessation of early venous filling, and improved flow to the adjacent parenchyma.
RESULTS: Four cases were identified, with a mean age of 15 years 1 month. Embolization was indicated due to long-term persistence and increasing lesion size on serial imaging. US and computed tomography (CT) were used for procedural planning. In all cases, a femoral arterial access approach was used, with a combination of two detachable coils (anchoring and packing), obtaining AVF occlusion. A 100% technical success rate was achieved. This has persisted in postprocedure imaging follow-up (mean follow-up: 17 months [2-36]). No minor or major adverse events were observed.
CONCLUSION: This study illustrates that embolization with detachable coils is a viable option to treat postbiopsy kidney transplant AVF in children. An anchoring and packing coil combination was feasible and effective in this small cohort.