[Arteriovenous fistula of the renal stump after nephrectomy]. / Fistula arteriovenosa renal secundaria a la ligadura en bloque del pedículo renal.

An arteriovenous fistula of the renal pedicle is a rare complication after nephrectomy. Most of cases we identify it time along after surgery. We present a case of an arteriovenous fistula of the right renal pedicle after nephrectomy done for pyonephrosis 40 years before. We comment the clinical features, treatment and evolution of the patient. We also review the actual literature.

[Supraselective embolization of renal pseudoaneurysm caused by an abdominal stab wound]. / Embolización supraselectiva de pseudoaneurisma renal por herida incisa abdominal.

OBJECTIVE: To report the results of conservative management of post-traumatic (abdominal stab wound) pseudoaneurysm with arteriovenous fistula in segmental artery of left kidney and secondary persistent hematuria in an HIV positive patient. METHODS/RESULTS: A supraselective left renal arteriography revealed a pseudoaneurysm. We performed embolization of the aneurysmal artery with coils and fibrin particles. Resolution of the hematuria was immediately achieved with no side effects or significant complications. CONCLUSIONS: In our view, supraselective embolization is the first option in the treatment of post-traumatic renal artery aneurysms due to its low morbidity and limited aggressiveness.

[Threatening hemoptysis. Results of treatment with arterial embolization]. / Hemoptisis amenazante. Resultados del tratamiento mediante embolización arterial.

OBJECTIVE: Retrospective analysis the immediate and long-term efficacy of embolization of bronchial and systemic arteries in the treatment of threatening or relapsing hemoptysis. MATERIALS AND METHODS: During the study period 122 arterial embolizations were performed in patients with hemoptysis over 100 ml in 24 hours, relapsing hemoptysis and/or presence of vital risk factors. Embolization was performed with polyvinyl alcohol particles, spongostan and metallic spirals. Seventy patients were included in the study and 47 were excluded as they came from other institutions. RESULTS: Angiographic changes were observed in 100% of patients. The immediate clinical success, defined as hemoptysis control, was obtained in the 70 patients. The mean follow-up time was 21.2 +/- 16.3 months. Relapsing hemoptysis occurred in 17.1% of patients (12 patients), of which 5.7% (4 cases) occurred in the first seven days and in 11.4% (8 patients) after 6 months. In five patients (7.1%) a new embolization was performed and 6 were operated after embolization (5 of them with bronchiectasis). The remarkable complications derived from the procedure included self-limited paraparesis of the lower limbs and severe chest pain. CONCLUSIONS: The embolization of bronchial arteries is an efficient technique for the treatment of threatening hemoptysis and relapses, is associated with a low morbidity rate, and the late relapse is relatively common among patiets with bronchiectasis.