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CardioVascular and Interventional Radiology

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01.10.2015 | Technical Note

Double Coaxial Microcatheter Technique for Glue Embolization of Renal Arteriovenous Malformations

verfasst von: Yoko Uchikawa, Kensaku Mori, Masanari Shiigai, Takahiro Konishi, Sodai Hoshiai, Toshitaka Ishigro, Takashi Hiyama, Yasunobu Nakai, Manabu Minami

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 5/2015

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Abstract

Purpose

To demonstrate the technical benefit of the double coaxial microcatheter technique for embolization of renal arteriovenous malformations (AVMs) with n-butyl cyanoacrylate and iodized oil (glue).

Materials and Methods

Six consecutive patients (1 man and 5 women; mean age 61 years; range 44–77 years) with renal AVMs were included. Five patients had hematuria, and one had a risk of heart failure due to a large intrarenal arteriovenous shunt. All patients underwent transarterial embolization using glue and the double coaxial microcatheter technique with outer 2.6F and inner 1.9F microcatheters. After glue injection, the inner microcatheter was retracted, while the outer microcatheter was retained. We assessed the complications and clinical outcomes of this technique.

Results

Technical success was achieved in all patients. In 9 sessions, 34 feeding arteries were embolized with glue using the double coaxial microcatheter technique, 1 was embolized with glue using a single microcatheter, and 2 were embolized with coils. The double coaxial microcatheter technique was useful for selecting small tortuous feeding arteries, preventing glue reflux to the proximal arteries, and approaching multiple feeding arteries without complete retraction of the microcatheters. As a minor complication, glue migrated into the venous system in four patients without any sequelae. In all patients, favorable clinical outcomes, including hematuria cessation in five patients and improvement of the large intrarenal arteriovenous shunt in one patient, were obtained without deterioration of renal function.

Conclusion

Glue embolization with the double coaxial microcatheter technique was useful for treating renal AVMs with multiple tortuous feeding arteries.

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Titel: Double Coaxial Microcatheter Technique for Glue Embolization of Renal Arteriovenous Malformations
verfasst von: Yoko Uchikawa
Kensaku Mori
Masanari Shiigai
Takahiro Konishi
Sodai Hoshiai
Toshitaka Ishigro
Takashi Hiyama
Yasunobu Nakai
Manabu Minami
Publikationsdatum: 01.10.2015
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 5/2015
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-015-1188-y

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Double Coaxial Microcatheter Technique for Glue Embolization of Renal Arteriovenous Malformations