CTICasesRenocaval Arteriovenous Fistula
Imaging findings
CT angiography of the abdomen shows massive, aneurysmal dilation of the left renal vein and inferior vena cava (IVC) in a patient who underwent a prior left nephrectomy, demonstrating a direct high-flow renocaval arteriovenous fistula (AVF) arising from the left renal artery stump.
Key takeaways
Renocaval AVFs are rare vascular complications that can develop years after nephrectomy, typically resulting from mass ligation of the renal artery and vein. The high-volume shunt causes marked venous hypertension, right heart volume overload, and high-output cardiac failure. Transcatheter embolization is highly effective.
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