Figure 7.

Patient with a massive long-standing renal arteriovenous fistula (AVF) that resulted in heart failure. (A) Digital subtraction angiogram shows large AVF massive dilatation of the renal vein. (B) Access was obtained in the arterial and venous systems. An Amplatzer plug was placed through the venous system (arrow) in the exact location of the fistula. (C) Radiograph shows multiple coils were placed inside the plug (arrow) to increase thrombosis. (D) Digital subtraction angiogram after embolization shows successful exclusion of the fistula. Note that the renal artery branches are now seen. Case courtesy of Barth Dolmatch, M.D., UT Southwestern, Dallas.