Fig. 3

A 33-year-old man was admitted to the emergency department because of acute right flank pain and severe macroscopic haematuria and laboratory findings like the case described in Figs. 1 and 2. Contrast CT scan revealed a “bag-of-worms”-like mass in the middle portion of the right kidney (not shown). a Emergency angiography with selective catheterisation of the right renal artery confirmed an area of tortuous, coiled vascular channels with early filling of the renal vein within a few seconds after contrast injection in the centre of the kidney (arrow). These findings confirmed the RAVM diagnosis, which appeared to receive blood supply from three small arterial branches. b Two of the feeding branches were successfully embolised with metallic coils of 3 × 2.6 (n = 4) mm diameter (2D Helical-35, Boston Scientific, Cork, Ireland). c The middle feeding branch was closer to the nidus (arrow), and embolisation by injection of tissue NBCA glue (GlueBran2, GEM S.r.l., Viareggio, Italy) was chosen. The final angiogram showed a good post-embolisation result. The haematuria stopped and the patient recovered within the next days