Arteriovenous Fistula Complicating Transjugular Renal Biopsy

Percutaneous renal biopsy with sonographic guidance is the standard by which renal tissue is sampled. In patients with uncorrectable coagulopathy or other contra-indication, percutaneous biopsy may not be feasible and a transvenous approach is preferred. This method limits the risk of bleeding complications as tissue is obtained endovascularly without transgression of the renal capsule. Arteriovenous fistula (AVF), a well-documented complication of percutaneous biopsy, has yet to be reported when done from a transvenous route. This report describes a case of iatrogenic arteriovenous fistula following transjugular renal biopsy necessitating selective arterial embolization. Clinical features are reviewed in addition to spot fluoroscopic images from transarterial coil embolization of the AVF.