Renal arteriovenous malformation treated using glue embolization under inflow and outflow control by balloon occlusion.

A 45-year-old female presented with gross hematuria. Right renal arteriovenous malformation on abdominal contrast-enhanced computed tomography necessitated urgent transcatheter arterial embolization. Right renal digital subtraction angiography revealed a single tortuous and dilated vessel converging to an aneurysmal dilated vein. To selectively embolize the malformation, we closed the arterial side with a microballoon and attempted glue embolization; filling occurred unexpectedly early, and another balloon on the vein side helped control the renal vein blood flow. Glue embolization was performed without adverse events. Glue embolization for high-flow arteriovenous malformation under balloon occlusion-mediated inflow and outflow control can effectively and safely embolize complete target vessels.

A case of blindness caused by Lemierre's syndrome.

Key Clinical Message: We describe a patient who lost her vision because of Lemierre's syndrome. Ophthalmologic complications of Lemierre's syndrome are rare, and very few cases have been reported. Clinicians need to recognize that it is a serious condition that can lead to blindness in some cases. Abstract: Lemierre's syndrome is a systemic septic embolism resulting from thrombophlebitis of the internal jugular vein. We report a case of blindness caused by Lemierre's syndrome, despite prompt diagnosis and early treatment. A 36-year-old woman was transported to our hospital. She presented with fever, facial swelling, and right visual acuity deterioration. Contrast-enhanced computed tomography revealed a retropharyngeal abscess and right internal jugular vein thrombosis. Blood culture revealed Fusobacterium necrophorum, suggesting Lemierre's syndrome. The patient had septic shock and disseminated intravascular coagulation. We diagnosed her visual impairment as orbital-apex syndrome due to spread of inflammation. After 6 weeks of antimicrobial drug treatments, her general condition had improved, and the retropharyngeal abscess had disappeared. On Day 49 of her illness, she was transferred to a rehabilitation hospital, but her visual acuity was not restored. Clinicians should be aware that Lemierre's syndrome can, although rarely, cause blindness.