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Experimental and Clinical... Jun 2023In patients with end-stage renal disease, arteriovenous fistulas are the standard of care to ensure long-term vascular access. Recent studies suggest some long-term...
OBJECTIVES
In patients with end-stage renal disease, arteriovenous fistulas are the standard of care to ensure long-term vascular access. Recent studies suggest some long-term posttransplant cardiac benefits and quality of life improvements in kidney transplant recipients due to arteriovenous fistula ligation. However, there are no guidelines regarding arteriovenous fistula management after transplant. Our study objective was to evaluate the long-term safety of arteriovenous fistula ligation and the frequency of returning to hemodialysis after ligation.
MATERIALS AND METHODS
Retrospective chart review from February 2014 to December 2020 identified 578 adult patients who underwent successful kidney transplant at our center. Of these patients, 47 underwent subsequent arteriovenous fistula ligation. Both medically driven and patient-driven cases were assessed and approved by a transplant nephrology team with regard to allograft function and ligation suitability.
RESULTS
Our results showed that, of the 47 renal transplant patients, 70.2% chose to undergo arteriovenous fistula ligation due to aneurysmal formation, 44.7% due to pain, and 14.9% due to high-output heart failure. In total, 68.1% of arteriovenous fistula ligations performed were primarily patient driven. There was an average follow-up of 2.9 years after ligation, with 1 unrelated reoperation and no returns to dialysis for all patients who underwent arteriovenous fistula ligation.
CONCLUSIONS
In our study, the long-term risks of surgical complications and allograft impairment after ligation were negligible. As a result of our current findings and known positive cardiovascular benefit, patient-driven arteriovenous fistula ligation after kidney transplant should be routinely considered in patients with stable allograft function.
Topics: Adult; Humans; Kidney Transplantation; Retrospective Studies; Quality of Life; Arteriovenous Shunt, Surgical; Treatment Outcome; Renal Dialysis; Kidney Failure, Chronic; Arteriovenous Fistula; Ligation
PubMed: 37455468
DOI: 10.6002/ect.2023.0024 -
Journal of Neurological Surgery. Part... Mar 2019Lhermitte-Duclos disease is a rare condition with less than 250 cases reported in the literature. It was considered a neoplastic or hamartomatous growth in the... (Review)
Review
Lhermitte-Duclos disease is a rare condition with less than 250 cases reported in the literature. It was considered a neoplastic or hamartomatous growth in the cerebellum. It commonly presents with symptoms of high intracranial pressure or obstructive hydrocephalus. Surgical resection is often curative. The lesion is associated with PTEN gene mutation, and it is considered to be one of the diagnostic criteria of Cowden's syndrome. Vascular tumors are reported in this syndrome, including glioblastomas and meningiomas. Furthermore, central nervous system vascular lesions were also reported in Lhermitte-Duclos disease, such as deep venous anomalies and brain arteriovenous fistulas. A report of an asymptomatic spinal cervical AVF in a patient with Lhermitte-Duclos disease was published in 2006. We present the second case of Lhermitte-Duclos disease associated with an asymptomatic spinal cervical AVF in a 17-year-old young woman with literature review of central nervous system vascular lesions in Lhermitte-Duclos disease.
Topics: Adolescent; Arteriovenous Fistula; Female; Hamartoma Syndrome, Multiple; Humans
PubMed: 30517962
DOI: 10.1055/s-0038-1670636 -
Annals of Neurology Apr 2022
Topics: Arteriovenous Fistula; Arteriovenous Malformations; Capillaries; Humans; Port-Wine Stain; Vascular Malformations
PubMed: 35152468
DOI: 10.1002/ana.26316 -
Renal Failure Dec 2024This study aimed to investigate ultrasound features of arteriovenous fistula stenosis and their relationship with primary patency after percutaneous transluminal...
This study aimed to investigate ultrasound features of arteriovenous fistula stenosis and their relationship with primary patency after percutaneous transluminal angioplasty (post-intervention primary patency) and compare this classification with that using lesion location. Hemodialysis patients who underwent ultrasound-guided percutaneous transluminal angioplasty for arteriovenous fistula stenosis from July 2020 to December 2021 were retrospectively evaluated. Lesions (excluding inflow arteries) were categorized into five groups based on ultrasound features, and the clinical characteristics and risk factors affecting the post-intervention primary patency of the arteriovenous fistula were analyzed. Among 185 patients, 100 (54.05%), 36 (19.46%), 22 (11.89%), 11 (5.95%), and 16 (8.65%) were classified into the intima-dominant, non-intima-dominant, valve obstruction, vascular calcification, and mixed groups, respectively. The dialysis duration and arteriovenous fistula use time were the highest in the vascular calcification group at 86 (interquartile range: 49-140) and 77 (interquartile range: 49-110) months, respectively. Diabetes mellitus was most common in the intima-dominant group (42.0%). In Kaplan-Meier and univariate Cox analysis, type III lesion location (stenosis in the venous confluence site) was associated with the lower post-intervention primary patency. In the multivariate Cox analysis, percutaneous transluminal angioplasty times (the number of times patients were treated with percutaneous transluminal angioplasty for arteriovenous fistula stenosis dysfunction), vascular calcification, calcification at the lesion site requiring percutaneous transluminal angioplasty, and serum parathyroid hormone levels were independent risk factors for post-intervention primary patency. Ultrasound features showed that calcification of the arteriovenous fistula was detrimental to the post-intervention primary patency of arteriovenous fistula.
Topics: Humans; Constriction, Pathologic; Retrospective Studies; Ultrasonography; Vascular Calcification; Arteriovenous Fistula
PubMed: 38186351
DOI: 10.1080/0886022X.2023.2294148 -
European Journal of Vascular and... Sep 2023
Topics: Humans; Arteriovenous Fistula; Arteriovenous Shunt, Surgical; Renal Dialysis; Vascular Patency; Treatment Outcome
PubMed: 37423601
DOI: 10.1016/j.ejvs.2023.07.006 -
Journal of Travel Medicine Jun 2023
Topics: Animals; Humans; Skates, Fish; Arteriovenous Fistula; Renal Dialysis
PubMed: 36006830
DOI: 10.1093/jtm/taac098 -
Neurosciences (Riyadh, Saudi Arabia) Jan 2023A 65-year-old male patient presented with a rare arterio-venous fistula (AFV). The symptoms included congestion, decreased visual acuity, and proptosis. Further...
A 65-year-old male patient presented with a rare arterio-venous fistula (AFV). The symptoms included congestion, decreased visual acuity, and proptosis. Further investigation revealed a non-traumatic intra orbital AFV with ophthalmic vein thrombosis. The management strategy was craniotomy and the prescription of anticoagulants. The patient recovered 2 months after surgery demonstrating successful resolution of his presenting symptoms and an alternative approach to complicated cases of embolization.
Topics: Male; Humans; Aged; Arteriovenous Fistula; Exophthalmos; Venous Thrombosis; Embolization, Therapeutic
PubMed: 36617457
DOI: 10.17712/nsj.2023.1.20220012 -
Journal of Vascular and Interventional... Sep 2023
Topics: Humans; Kidney; Nephrectomy; Biopsy; Arteriovenous Fistula; Renal Veins
PubMed: 37019428
DOI: 10.1016/j.jvir.2023.03.032 -
The British Journal of Radiology Jul 2018The term "paraspinal arteriovenous shunts" (PAVSs) summarizes an inhomogeneous variety of rare vascular disorders. PAVSs have been observed as congenital or acquired... (Review)
Review
The term "paraspinal arteriovenous shunts" (PAVSs) summarizes an inhomogeneous variety of rare vascular disorders. PAVSs have been observed as congenital or acquired lesions. The clinical course of PAVSs may be asymptomatic or present with life-threatening symptoms. Based on a collection of individual cases from three institutions and a literature evaluation, we propose the following classification: PAVSs that are part of a genetic syndrome are separated from "isolated" PAVSs. Isolated PAVSs are subdivided into "acquired", "traumatic" and "congenital" without an identifiable genetic hereditary disorder. The subgroups are differentiated by the route of venous drainage, being exclusively extraspinal or involving intraspinal veins. PAVSs associated to a genetic syndrome may either have a metameric link or occur together with a systemic genetic disorder. Again extra-vs intraspinal venous drainage is differentiated. The indication for treatment is based on individual circumstances (e.g. myelon compression, vascular bruit, high volume output cardiac failure). Most PAVSs can be treated by endovascular means using detachable coils, liquid embolic agents or stents and derivates.
Topics: Adult; Aged; Arteriovenous Fistula; Child; Female; Humans; Male; Middle Aged; Spine
PubMed: 29376731
DOI: 10.1259/bjr.20170337 -
Journal of Veterinary Internal Medicine Sep 2022Three young adult cats with intermittent spinal hyperesthesia and paraparesis and diagnosed with spinal epidural arteriovenous fistula are described. In all 3 cases,...
Three young adult cats with intermittent spinal hyperesthesia and paraparesis and diagnosed with spinal epidural arteriovenous fistula are described. In all 3 cases, magnetic resonance imaging (MRI) showed focal dilatation of the veins in the epidural space of the thoracic spinal cord, whereas computed tomography angiography (CTA) showed dilatation and enhancement from the intercostal vein to the azygos vein at the same site in the arterial phase. Dorsal laminectomy and occlusion of the interarcuate branches running across the dorsal aspect of the spinal cord were performed in all 3 cats to decompress the spinal cord, which resulted in a remission of clinical signs and no recurrence during 14 to 40 months of follow-up after surgery in all cases.
Topics: Angiography; Animals; Arteriovenous Fistula; Epidural Space; Laminectomy; Magnetic Resonance Imaging; Spinal Cord
PubMed: 35983913
DOI: 10.1111/jvim.16523