# Management challenges in renal arteriovenous malformation mimicking AVF/pseudoaneurysm without trauma or pathological cause

## TL;DR

This paper discusses the challenges of diagnosing and treating a rare kidney blood vessel abnormality that mimics other conditions and required surgery due to high risk of complications.

## Contribution

The paper presents a rare case of non-traumatic renal AVM managed surgically due to endovascular risks.

## Key findings

- A 33-year-old male presented with a high-flow renal AVM and multiple aneurysms without trauma or pathology.
- Endovascular embolization was not feasible due to the risk of pulmonary embolism.
- Open surgical repair successfully managed the AVM, highlighting the role of surgery in complex cases.

## Abstract

Renal arteriovenous malformations (AVMs) are rare and often pose diagnostic and management challenges, especially in the absence of trauma or underlying pathology. We report a case of a 33-year-old male with a long-standing renal artery aneurysm who presented with flank pain. Imaging revealed a high-flow renal AVM with multiple aneurysms, the largest measuring 30 mm. An attempted embolization was aborted due to the risk of pulmonary embolism. Open surgical repair was performed, involving ligation of the affected arterial branches. This case highlights the complexities in managing non-traumatic renal AVMs and the role of surgery when endovascular treatment is not feasible.

•Renal arteriovenous malformations (RAVMs) are rare vascular anomalies that can mimic AVFs and pseudoaneurysms, making accurate diagnosis essential for proper management.•This case involved a high-flow renal AVM with associated aneurysms in a patient without trauma or prior interventions, presenting unique diagnostic and therapeutic challenges.•Endovascular embolization was deemed unsafe due to the high-flow dynamics and risk of pulmonary embolism, necessitating open surgical intervention.•The successful surgical outcome emphasizes the importance of individualized, multidisciplinary approaches in managing complex renal vascular anomalies.

Renal arteriovenous malformations (RAVMs) are rare vascular anomalies that can mimic AVFs and pseudoaneurysms, making accurate diagnosis essential for proper management.

This case involved a high-flow renal AVM with associated aneurysms in a patient without trauma or prior interventions, presenting unique diagnostic and therapeutic challenges.

Endovascular embolization was deemed unsafe due to the high-flow dynamics and risk of pulmonary embolism, necessitating open surgical intervention.

The successful surgical outcome emphasizes the importance of individualized, multidisciplinary approaches in managing complex renal vascular anomalies.