Methylene blue-guided parenchyma-sparing ex vivo resection and autotransplantation for a type III renal arteriovenous fistula with large renal vein aneurysm: A technical case report.
- 1Unit of Vascular Surgery, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., Rome, Italy.
- 2Unit of Vascular Surgery, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S. - Università Cattolica del Sacro Cuore, Rome, Italy.
Abstract
High-flow renal arteriovenous malformations (AVMs), type III with vein aneurysms, are rare and often require nephrectomy. A 54-year-old man presented with lumbar pain and hematuria. Computed tomography angiography revealed an 8- × 12-cm right renal vein aneurysm and a type III arteriovenous fistula occupying >30% of the kidney. After ex vivo nephrectomy with cold perfusion, selective methylene blue injection delineated the AVM nidus and parenchyma, guiding resection and excision. The procedure was performed by a multidisciplinary team including a vascular surgeon, transplant surgeon, and urologist. The kidney was reconstructed and reimplanted. Postoperative creatinine levels stabilized at 1.10 mg/dL, and computed tomography angiography confirmed AVM exclusion and preserved perfusion. Methylene blue mapping can enable parenchyma-sparing repair in selected cases.
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BibTeX
@article{borghese2026methylene,
title = {{Methylene blue-guided parenchyma-sparing ex vivo resection and autotransplantation for a type III renal arteriovenous fistula with large renal vein aneurysm: A technical case report.}},
author = {Ottavia Borghese and Francesco Sposato and Yamume Tshomba},
journal = {Journal of vascular surgery cases and innovative techniques},
year = {2026},
month = sep,
doi = {10.1016/j.jvscit.2026.102511},
url = {https://europepmc.org/article/MED/42898592},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Methylene blue-guided parenchyma-sparing ex vivo resection and autotransplantation for a type III renal arteriovenous fistula with large renal vein aneurysm: A technical case report.
AU - Ottavia Borghese
AU - Francesco Sposato
AU - Yamume Tshomba
PY - 2026
DA - 2026/09/16
JO - Journal of vascular surgery cases and innovative techniques
DO - 10.1016/j.jvscit.2026.102511
UR - https://europepmc.org/article/MED/42898592
AB - High-flow renal arteriovenous malformations (AVMs), type III with vein aneurysms, are rare and often require nephrectomy. A 54-year-old man presented with lumbar pain and hematuria. Computed tomography angiography revealed an 8- × 12-cm right renal vein aneurysm and a type III arteriovenous fistula occupying >30% of the kidney. After ex vivo nephrectomy with cold perfusion, selective methylene blue injection delineated the AVM nidus and parenchyma, guiding resection and excision. The procedure was performed by a multidisciplinary team including a vascular surgeon, transplant surgeon, and urologist. The kidney was reconstructed and reimplanted. Postoperative creatinine levels stabilized at 1.10 mg/dL, and computed tomography angiography confirmed AVM exclusion and preserved perfusion. Methylene blue mapping can enable parenchyma-sparing repair in selected cases.
SN - 2468-4287
ER -