Kodama K et al, 2018: Renal arteriovenous fistula induced by extracorporeal shock wave lithotripsy treated by retroperitoneoscopic nephrectomy.
Kodama K, Takase Y, Tokai R, Saito K.
Department of Urology, Department of Pathology, Toyama City Hospital, Toyama, Japan.
Abstract
Renal arteriovenous fistula (AVF) is a rare but potentially severe and life-threatening entity. It can occur after various invasive renal interventions, including resection of a localized renal tumor, renal biopsy, percutaneous renal surgery, and even blunt injury of the kidney. The time of clinical presentation of a renal AVF is variable and may occur decades after the injury originally occurred. Here, we report a case of renal AVF induced by extracorporeal shock wave lithotripsy 11 years earlier in an asymptomatic 72-year-old woman. Given the patient's pre-existing hemodialysis dependence, retroperitoneoscopic nephrectomy was performed. On the basis of patient's clinical history, the location of the renal AVF, and the pathological diagnosis, we suggested that renal AVF was a late consequence of the injury to the intrarenal vessels induced by extracorporeal shock wave lithotripsy.
Asian J Endosc Surg. 2018 Sep 21. doi: 10.1111/ases.12651. [Epub ahead of print]
Comments 1
In this case report the authors describe an arterio-venous fistula considered to be a late consequence of SWL. Treatment with SWL for removal of lower calyx stones had been carried out 11 (!) years earlier.
Arterio-venous fistula is a very unusual complication of SWL; rarely described in the literature and most certainly seldom encountered in the clinic.
It is likely that the patient’s arteriosclerosis and nephrosclerosis played a role in this process. End-stage renal insufficiency facilitated the therapeutic decision.