Endovascular Embolization versus Observation of Congenital Renal Arteriovenous Malformations: A Retrospective Study.

Abstract

This report retrospectively compares outcomes associated with endovascular embolization and observation in patients with congenital renal arteriovenous malformations (AVM). Chart and imaging review of patients at a single center with congenital renal AVM was performed. Patient demographics, Yakes classification, renal vessel size, and presenting symptoms were recorded. Procedural imaging and follow-up data were analyzed to identify adverse events, complications, and potential advantages of embolization over observation. Eighteen patients had congenital renal AVM, 11 were observed and 7 underwent transarterial embolization. There were a significantly greater number of patients with complications related to the AVM in the observation group compared to patients with adverse events in the embolization group (p=0.0148). This includes 2 observed patients with AVM rupture requiring nephrectomy both of whom had type I AVM. Endovascular embolization should be considered for all patients with congenital renal AVM. Specifically, Yakes type I AVM may deserve special consideration for intervention.