Uterine Arteriovenous Fistula with Concomitant Pelvic Varicocele: Endovascular Embolization with Onyx-18®

Figure 2

Procedural imaging and digital subtraction angiography. (a) Pelvic angiogram after 5Fr pigtail catheter positioning in abdominal aorta showing the vascular lesion in arterious phase injection. (b) Selective left uterine arteriography by 5Fr Cobra catheterization positioned crossing the aortic carrefour (white arrow): ectatic and aberrant arterious vessels with concomitant ectatic and serpiginous direct venous outflow, confirming the AVF diagnosis. (c) Selective right uterine arteriography by 5Fr Robert Uterine Curve catheterization (white arrow): involvement of the right uterine artery in terms of inflow to the AVF. ((d) and (e)) Left and right postembolization hypogastric artery angiography, respectively: complete occlusion of the uterine arteries after Onyx-18 injection and preservation of the other hypogastric branches; the Onyx-18 cast is indicated by the black arrows. (f) Final pelvic angiogram: the AVF is no more appreciable after embolization with Onyx-18 (black arrows indicate the casts).

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