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Neurology Nov 2020Brain arteriovenous malformations (AVMs) are anomalous direct shunts between cerebral arteries and veins that convalesce into a vascular nidus. The treatment strategies... (Review)
Review
Brain arteriovenous malformations (AVMs) are anomalous direct shunts between cerebral arteries and veins that convalesce into a vascular nidus. The treatment strategies for AVMs are challenging and variable. Intracranial hemorrhage and seizures comprise the most common presentations of AVMs. However, incidental AVMs are being diagnosed with increasing frequency due to widespread use of noninvasive neuroimaging. The balance between the estimated cumulative lifetime hemorrhage risk vs the risk of intervention is often the major determinant for treatment. Current management options include surgical resection, embolization, stereotactic radiosurgery (SRS), and observation. Complete nidal obliteration is the goal of AVM intervention. The risks and benefits of interventions vary and can be used in a combinatorial fashion. Resection of the AVM nidus affords high rates of immediate obliteration, but it is invasive and carries a moderate risk of neurologic morbidity. AVM embolization is minimally invasive, but cure can only be achieved in a minority of lesions. SRS is also minimally invasive and has little immediate morbidity, but AVM obliteration occurs in a delayed fashion, so the patient remains at risk of hemorrhage during the latency period. Whether obliteration can be achieved in unruptured AVMs with a lower risk of stroke or death compared with the natural history of AVMs remains controversial. Over the past 5 years, multicenter prospective and retrospective studies describing AVM natural history and treatment outcomes have been published. This review provides a contemporary and comprehensive discussion of the natural history, pathobiology, and interventions for brain AVMs.
Topics: Arteriovenous Fistula; Humans; Intracranial Arteriovenous Malformations; Outcome Assessment, Health Care
PubMed: 33004601
DOI: 10.1212/WNL.0000000000010968 -
Handbook of Clinical Neurology 2021Dural arteriovenous fistulae (dAVFs) are diverse, complex lesions that share the common feature of arteriovenous shunting without an intervening nidus. In this chapter,... (Review)
Review
Dural arteriovenous fistulae (dAVFs) are diverse, complex lesions that share the common feature of arteriovenous shunting without an intervening nidus. In this chapter, the ensuing discussion is organized by dAVF location, followed by further consideration of less common, distinct types of dAVFs-carotid cavernous fistulae, pial arteriovenous fistulae, and vein of Galen malformations. For each lesion type, epidemiology, clinical presentation, imaging findings, classification considerations, and treatment options are discussed.
Topics: Arteriovenous Fistula; Central Nervous System Vascular Malformations; Cerebral Angiography; Cerebral Veins; Humans; Neurosurgical Procedures
PubMed: 33272395
DOI: 10.1016/B978-0-444-64034-5.00004-3 -
Annals of Vascular Surgery Sep 2022Intimal hyperplasia (IH), a crucial histopathological injury, forms the basis of vascular stenosis and thrombogenesis. In addition, it is common in maladies such as... (Review)
Review
Intimal hyperplasia (IH), a crucial histopathological injury, forms the basis of vascular stenosis and thrombogenesis. In addition, it is common in maladies such as stenosis at the anastomosis of arteriovenous fistula and restenosis after angioplasty. Various cellular and noncellular components play critical parts in the advancement of IH. This article reviews the distinctive components of IH, such as endothelial dysfunction, multiplication, and movement of vascular smooth muscle cells. Finally, in addition to synthesis of large amounts of extracellular matrix and inflammatory responses, which have frequently been studied in recent years, we offer a premise for clinical treatment with vascular smooth muscle cells.
Topics: Arteriovenous Fistula; Constriction, Pathologic; Humans; Hyperplasia; Treatment Outcome; Tunica Intima
PubMed: 35472499
DOI: 10.1016/j.avsg.2022.04.030 -
Journal of Vascular Surgery. Venous and... Mar 2024
Topics: Humans; Arteriovenous Fistula; Pulmonary Veins; Pulmonary Artery
PubMed: 37972756
DOI: 10.1016/j.jvsv.2023.101717 -
Seminars in Neurology Jun 2020Children can have a variety of intracranial vascular anomalies ranging from small and incidental with no clinical consequences to complex lesions that can cause... (Review)
Review
Children can have a variety of intracranial vascular anomalies ranging from small and incidental with no clinical consequences to complex lesions that can cause substantial neurologic deficits, heart failure, or profoundly affect development. In contrast to high-flow lesions with direct arterial-to-venous shunts, low-flow lesions such as cavernous malformations are associated with a lower likelihood of substantial hemorrhage, and a more benign course. Management of vascular anomalies in children has to incorporate an understanding of how treatment strategies may affect the normal development of the central nervous system. In this review, we discuss the etiologies, epidemiology, natural history, and genetic risk factors of three high-flow vascular malformations seen in children: brain arteriovenous malformations, intracranial dural arteriovenous fistulas, and vein of Galen malformations.
Topics: Arteriovenous Fistula; Child; Embolization, Therapeutic; Humans; Intracranial Arteriovenous Malformations; Radiosurgery
PubMed: 32252098
DOI: 10.1055/s-0040-1708869 -
Journal de Medecine Vasculaire Feb 2023Arteriovenous fistula (AVF) are the preferred hemodialysis vascular access. However, central venous catheter (CVC) placement rates remain very high in patients...
Arteriovenous fistula (AVF) are the preferred hemodialysis vascular access. However, central venous catheter (CVC) placement rates remain very high in patients initiating hemodialysis and/or in whom with a fistula dysfunction. Several complications are associated with the insertion of these catheters, including infection, thrombosis and arterial injuries. Iatrogenic AVF are uncommon complications. Herein, we report the case of a 53-year-old female with an iatrogenic right subclavian artery - internal jugular vein fistula secondary to a right internal jugular catheter malposition. Through a median sternotomy combined with supraclavicular approach, AVF exclusion with direct suture of subclavian artery and the internal jugular vein was performed. The patient was discharged without any complications.
Topics: Female; Humans; Middle Aged; Catheterization, Central Venous; Arteriovenous Fistula; Renal Dialysis; Thrombosis; Iatrogenic Disease
PubMed: 37120271
DOI: 10.1016/j.jdmv.2022.12.002 -
Hypertension (Dallas, Tex. : 1979) May 2019
Topics: Antihypertensive Agents; Arteriovenous Fistula; Computed Tomography Angiography; Diagnosis, Differential; Drug Resistance; Embolization, Therapeutic; Female; Humans; Hypertension; Magnetic Resonance Imaging; Middle Aged; Renal Artery; Renal Veins
PubMed: 30905196
DOI: 10.1161/HYPERTENSIONAHA.118.12068 -
Medicina (Kaunas, Lithuania) Mar 2021Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial... (Review)
Review
Interventional radiology of the male urogenital system includes percutaneous and endovascular procedures, and these last consist mostly of transcatheter arterial embolizations. At the kidney level, arterial embolizations are performed mainly for palliative treatment of parenchymal tumors, for renal traumas and, less frequently, for arteriovenous fistulas and renal aneurysms and pseudoaneurysms. These latter may often require emergency intervention as they can cause renal or peri-renal hematomas or significant hematuria. Transcatheter arterial embolization is also an effective therapy for intractable severe bladder hematuria secondary to a number of neoplastic and inflammatory conditions in the pelvis, including unresectable bladder cancer and radiation-induced or cyclophosphamide-induced hemorrhagic cystitis. Endovascular interventional procedures for the penis are indicated for the treatment of post-traumatic priapism. In this article, we review the main endovascular radiological interventions of the male urogenital system, describing the technical aspects, results, and complications of each procedure at the various anatomical districts.
Topics: Aneurysm, False; Arteriovenous Fistula; Embolization, Therapeutic; Endovascular Procedures; Humans; Male; Radiology, Interventional; Treatment Outcome
PubMed: 33802895
DOI: 10.3390/medicina57030278 -
Neurology India 2023
Topics: Humans; Arteriovenous Fistula; Embolization, Therapeutic
PubMed: 37929418
DOI: 10.4103/0028-3886.388121 -
Expert Review of Medical Devices Mar 2021Surgically created arteriovenous fistulas are the accepted gold standard for the establishment of hemodialysis access in patients requiring dialysis. However, primary... (Review)
Review
INTRODUCTION
Surgically created arteriovenous fistulas are the accepted gold standard for the establishment of hemodialysis access in patients requiring dialysis. However, primary and maturation failures may limit their usage. Recent advances in endovascular technology have resulted in the creation of devices for endovascular arteriovenous fistula formation. These devices may offer an additional or alternative approach to fistula formation in patients with end-stage kidney disease.
AREAS COVERED
This review describes the limitations of surgical arteriovenous fistulas and the endovascular devices currently available. The review covers initial trial data and subsequent studies examining their use.
EXPERT OPINION
Early results achieved with endovascular fistula formation are encouraging. Current limitations of this technology include anatomic suitability and a high rate of re-interventions required to establish maturity. Greater uptake of the technology will also require a review of long-term outcomes in larger patient cohorts.
Topics: Arteriovenous Fistula; Clinical Trials as Topic; Endovascular Procedures; Humans; Renal Dialysis; Treatment Outcome
PubMed: 33688779
DOI: 10.1080/17434440.2021.1899806