Figure 3

Selective left renal angiogram demonstrates the hypertrophic peripheral renal artery branches in the lower pole (arrowheads in first panel) with a large nidus (arrowhead in second panel), and rapid shunting to the lower pole renal vein (arrow in the third panel). A balloon catheter has been placed in the left renal vein to prevent reflux of the embolic agent (arrow in fourth panel), and superselective catheterization of the left lower pole renal artery has been performed using a microcatheter (arrowhead in fourth panel). Selected image after embolization of the renal arteriovenous malformation with absolute alcohol and polyvinyl alcohol particles show truncation of the hypertrophic left lower pole peripheral renal artery branches with absence of shunting to the lower pole renal vein (fifth panel).