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Richard M. Ehrlich, MD

Arch Surg. 1975;110(10):1195-1198.

Abstract
A renal arteriovenous fistula responsible for diastolic hypertension was repaired without sacrificing renal parenchyma by endofistulorrhaphy, a unique surgical technique.

The fistula site was localized preoperatively by selective renal arteriography. The renal artery was incised and the ostium of the efferent venous channel suture-ligated from within the depths of the artery. The fistula was successfully interrupted, and the patient has remained normotensive. Postoperative arteriography confirmed the absence of the fistula.

Vascular surgical procedures sparing renal parenchyma are relatively new, as the most common treatment for this condition had been nephrectomy.

Author Affiliations
From the Department of Surgery, Division of Urology, University of California School of Medicine, Los Angeles.

Footnotes
Accepted for publication Feb 11, 1975.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Santa Barbara, Calif, Jan 19, 1975.

Reprint requests to Department of Surgery, Division of Urology, University of California School of Medicine, Los Angeles, CA 90024 (Dr. Ehrlich).

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