A safe surgical approach to a giant intrarenal arteriovenous fistula and aneurysm

Giant arteriovenous fistulas (AVF) pose a challenging management problem with respect to open surgery versus endovascular interventional techniques. Endovascular techniques may not be ideal for larger fistulas and may be associated with potential risks of embolism, whilst open surgery poses the risk of uncontrollable hemorrhage. We describe a safe surgical technique for this challenging problem.