Congenital renal arteriovenous malformation presenting as severe hypertension

Hypertensive patients presenting at the extremes ofage may have a secondary cause of hypertension.Congenital arteriovenous malformation (AVM) andacquired arteriovenous fistula (AVF) are rare causes ofsecondary hypertension w1–10x. Acquired AVFs tendto be single linear connecting vessels and comprise70–80% of renal arteriovenous abnormalities andusually result from trauma, biopsy, surgery, malig-nancy, or inflammation w1,3x. Congenital AVM isdescribed as crisoid with a knotted, tortuous appear-ance of numerous feeding vessels, and multipleinterconnecting fistulas; however, a variant called‘angiomatous’ AVM has a single vessel feeding mul-tiple small interconnecting vessels w1,4x. We present acase of hypertension secondary to congenital AVMmanaged by superselective embolization and a briefreview of the literature.