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Pediatric Dermatology 2023We report the case of a 12-month-old infant who presented with progressive lower limb enlargement associated with erythema mimicking an arteriovenous malformation....
We report the case of a 12-month-old infant who presented with progressive lower limb enlargement associated with erythema mimicking an arteriovenous malformation. Computed tomography confirmed an arteriovenous fistula (AVF) between the deep femoral artery and the common femoral vein. This case describes the unique clinical and imaging findings of iatrogenic AVF and contrasts them with other congenital vascular entities.
Topics: Humans; Infant; Arteriovenous Malformations; Arteriovenous Fistula; Tomography, X-Ray Computed; Contrast Media; Iatrogenic Disease
PubMed: 36565035
DOI: 10.1111/pde.15235 -
Child's Nervous System : ChNS :... Mar 2022Parkes Weber syndrome (PWS) is a rare and congenital vascular malformation manifesting as hemihypertrophy of the extremities, cutaneous hemangiomas, varicose veins, and...
BACKGROUND
Parkes Weber syndrome (PWS) is a rare and congenital vascular malformation manifesting as hemihypertrophy of the extremities, cutaneous hemangiomas, varicose veins, and arteriovenous fistula of the affected limbs. The incidence rate of spinal arteriovenous fistula (AVF) associated with PWS is extremely rare.
CASE PRESENTATION
We reported a case of an adolescent girl with PWS who presented with a rupture spinal perimedullary AVF at the level of T12-L1. She was successfully treated with emergent surgical decompression and subsequent endovascular embolization. The clinical features and treatment of spinal AVF associated with PWS were discussed and a brief literature review was presented.
CONCLUSION
Based on this case report, we suggested that the management of spinal AVF in PWS should also be individualized and be tailored according to the condition and expectation of the patients as well as the angioarchitecture of the vascular malformation.
Topics: Adolescent; Arteriovenous Fistula; Embolization, Therapeutic; Female; Humans; Spinal Cord; Spine; Sturge-Weber Syndrome; Varicose Veins
PubMed: 34129081
DOI: 10.1007/s00381-021-05187-8 -
Heart, Lung & Circulation Oct 2022In coronary artery bypass grafting (CABG) for haemodialysis patients, arteriovenous fistula can reduce blood flow from the internal mammary artery (IMA) graft. The...
BACKGROUND
In coronary artery bypass grafting (CABG) for haemodialysis patients, arteriovenous fistula can reduce blood flow from the internal mammary artery (IMA) graft. The purpose of this study was to delineate the rationale of ipsilateral IMA grafting to the arteriovenous fistula by assessing graft flow and patency.
METHOD
The clinical records of 139 haemodialysis patients who underwent off-pump CABG, including IMA grafting to the left anterior descending artery (LAD) between April 2007 and December 2018, were retrospectively reviewed. Clinical outcomes and transit-time flowmetry results of IMA to LAD bypass grafts during off-pump CABG and postoperative angiography were examined.
RESULTS
An ipsilateral IMA to the arteriovenous fistula (Ipsi-IMA) was used in 89 patients, and a contralateral IMA to the arteriovenous fistula (Contra-IMA) was used in 50 patients and no hospital deaths occurred. The mean graft flow and angiographic patency rate did not differ between the Ipsi-IMA and Contra-IMA groups. In patients with 51 to 90% stenosis of LAD, there was no significant difference in the mean graft flow. In comparison, in the patients with 91 to 100% stenosis of LAD, the mean graft flow in the Ipsi-IMA group was significantly lower than that in the Contra-IMA group (p=0.03). Kaplan-Meier analyses showed a 5-year survival rate of 57.6% for Ipsi-IMA and 64.8% for Contra-IMA (p=0.47).
CONCLUSIONS
In the revascularisation of the LAD, the graft patency rate of the Ipsi-IMA was not inferior to that of the Contra-IMA. However, when the LAD has 91 to 100% stenosis, a Contra-IMA to arteriovenous fistula may be beneficial in terms of sufficient flow capacity.
Topics: Arteriovenous Fistula; Constriction, Pathologic; Coronary Artery Bypass; Humans; Mammary Arteries; Retrospective Studies; Vascular Patency
PubMed: 35840512
DOI: 10.1016/j.hlc.2022.06.662 -
The Pan African Medical Journal 2022Aneurysms of the tibial arteries are rare, and they most commonly occur due to trauma of the lower extremities. Acquired arteriovenous fistulas of the tibial arteries...
Aneurysms of the tibial arteries are rare, and they most commonly occur due to trauma of the lower extremities. Acquired arteriovenous fistulas of the tibial arteries are a recognized complication of trauma of the lower extremity and they are related to the mechanism of the injury. Although the natural history of stable arteriovenous fistula is relatively benign, the aneurysms of the tibial arteries should be repaired with autologous vein bypass grafts, if there is distal ischemia. Endovascular repair has been reported as an effective alternative treatment for traumatic tibial artery aneurysms. The case of a 60-year-old male with the rare combination of a tibial artery aneurysm and traumatic arteriovenous fistula of the left lower extremity is reported in view of its rarity and the modern holistic endovascular approach used for treatment. A covered stent graft in the anterior tibial artery was used for the treatment of both the aneurysm and the arteriovenous fistula. The patient was discharged under dual antiplatelet treatment for three months, continued by clopidogrel as monotherapy. At the six-month follow-up, the patient has restored palpable peripheral pulses and no sign of recurrence or complication was recognized. A total endovascular approach can be an effective treatment for these complicated traumatic aneurysms.
Topics: Aneurysm; Arteriovenous Fistula; Humans; Male; Middle Aged; Stents; Tibial Arteries; Vascular System Injuries
PubMed: 36060853
DOI: 10.11604/pamj.2022.42.122.29735 -
The Neuroradiology Journal Apr 2017Background and importance Intraorbital arteriovenous fistulas (IOAVFs) are rare and cause eye redness, exophthalmos, blurry vision and bruit. Whereas in the past they... (Review)
Review
Background and importance Intraorbital arteriovenous fistulas (IOAVFs) are rare and cause eye redness, exophthalmos, blurry vision and bruit. Whereas in the past they were treated conservatively, surgically or transarterially, recent developments in transvenous embolization have improved their treatment. In this paper the authors report three cases of IOAVFs treated endovascularly and review the evolution of treatment options. Methods Three cases of purely IOAVF enrolled in our center were reported and a PubMed literature search was performed using "pure intraorbital arteriovenous fistula" and "arteriovenous fistula of the optic nerve sheath." A total of 21 papers were reviewed in full, focusing primarily on the treatment and outcomes. Results A total of 26 patients were obtained, including our three patients and 23 patients reported in the literature. In nine patients treated conservatively, four spontaneous occlusions, one visual deterioration and four cases with unknown outcome were reported. In another 18 patients, 29 therapies (including five surgical treatment, 11 transarterial embolizations and 13 transvenous embolizations) were attempted and resulted in 12 cures, five visual deteriorations and one without reported outcome. More recently, transvenous embolization has become the mainstay of IOAVF treatment. Of the 21 patients assessed between 2000 and 2013, a transvenous approach was attempted in 13 patients; nine patients were cured without any adverse events. Conclusion Development and improvement of transvenous techniques are found to be safe and effective for patients with IOAVF.
Topics: Aged; Arteriovenous Fistula; Cerebral Angiography; Embolization, Therapeutic; Female; Humans; Male; Middle Aged
PubMed: 28424011
DOI: 10.1177/1971400917692163 -
World Neurosurgery Dec 2020Craniocervical junction arteriovenous fistula (CCJAVF) has a variety of forms, including dural and perimedullary arteriovenous fistulas. Owing to this anatomic variety,...
BACKGROUND
Craniocervical junction arteriovenous fistula (CCJAVF) has a variety of forms, including dural and perimedullary arteriovenous fistulas. Owing to this anatomic variety, the terminologies for classifying CCJAVF, most of which aim to describe angiographic structures, have yet to be firmly established, and the current taxonomic classifications do not facilitate surgical strategies. Herein we focused on the existence of intradural feeder vessels, allowing the identification of 2 types of CCJAVF. This retrospective study aimed to assess the usefulness of our diagnostic classification for CCJAVF surgery.
METHODS
We divided CCJAVF into 2 types: CCJAVF with an intradural feeder vessel and CCJAVF without an intradural feeder vessel. For the former type, we set the surgical goal of interrupting the intradural feeder and the draining veins behind the posterior spinal nerve. For the latter type, the surgical goal was to interrupt the draining veins behind the posterior spinal nerve. We retrospectively analyzed the outcomes of our surgical cases.
RESULTS
Of 12 patients with CCJAVF, 8 underwent direct surgery. No patients showed exacerbation of neurological symptoms after surgery. One patient needed a second operation for residual shunt, and another patient developed an asymptomatic angiographic recurrence in the epidural space detected on follow-up imaging. The overall outcomes of surgical cases were good with an average modified Rankin Scale score of 1.0.
CONCLUSIONS
Our results indicate that our diagnostic classification for CCJAVF has the potential to simplify CCJAVF treatment without compromising patient outcomes.
Topics: Aged; Aged, 80 and over; Arteriovenous Fistula; Central Nervous System Vascular Malformations; Cerebral Angiography; Female; Humans; Male; Middle Aged; Retrospective Studies; Treatment Outcome
PubMed: 32942059
DOI: 10.1016/j.wneu.2020.09.041 -
Clinical Imaging Dec 2021We present a case of a 24 year old man who presented with high flow priapism. Priapism is defined as an erection lasting four or more hours, either after or unrelated...
We present a case of a 24 year old man who presented with high flow priapism. Priapism is defined as an erection lasting four or more hours, either after or unrelated to sexual stimulation. Priapism can be categorized into low-flow, stuttering, and high-flow types, each with unique mechanisms and treatments. High-flow priapism is caused by an abnormal communication between the artery and sinusoids of the penis, often in the form of an arteriovenous fistula. Super-selective embolization is the treatment of choice for high-flow priapism if conservative measures fail. Super-selective embolization is associated with an 80% success rate and a low chance of post-procedure erectile dysfunction.
Topics: Adult; Arteriovenous Fistula; Embolization, Therapeutic; Humans; Male; Penile Erection; Penis; Priapism; Young Adult
PubMed: 34425545
DOI: 10.1016/j.clinimag.2021.07.020 -
World Neurosurgery Feb 2017Spinal arteriovenous shunts are a common spinal vascular disorder. However, they can have a misleading clinical presentation and poor prognosis. They are classified into...
BACKGROUND
Spinal arteriovenous shunts are a common spinal vascular disorder. However, they can have a misleading clinical presentation and poor prognosis. They are classified into 4 types according to shunt points and drainage route, among which extradural arteriovenous fistula (eAVF) is the most rare, comprising only 1% of all spinal arteriovenous shunts. We report an extremely rare case of coexistent eAVF at the craniocervical junction and soft tissue arteriovenous malformation within the same metamere.
CASE DESCRIPTION
A 30-year-old man presented with neck pain. T2-weighted magnetic resonance imaging revealed a flow void at the right craniocervical junction compressing the spinal cord. Angiography revealed eAVF at the craniocervical junction. The patient was treated via transvenous embolization. After the procedure, shunt flow and symptoms markedly decreased. During the operation, an extracranial arteriovenous malformation under the occipital skin was detected immediately after occluding the shunt point.
CONCLUSIONS
This case indicates that transvenous embolization can be an effective treatment for eAVF and supports some hypotheses of arteriovenous malformation development. Additionally, it emphasizes the importance of examining a lesion with multiple modalities, including angiography, three-dimensional angiography, and cone-beam computed tomography, to understand the anatomy of the lesion.
Topics: Adult; Arteriovenous Fistula; Arteriovenous Malformations; Cone-Beam Computed Tomography; Embolization, Therapeutic; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Spinal Cord
PubMed: 27890761
DOI: 10.1016/j.wneu.2016.11.076 -
Journal Des Maladies Vasculaires Feb 2015Most popliteal arteriovenous fistula and pseudoaneurysm formation are related to trauma. Few cases have previously been reported after acupuncture therapy. Such events...
Most popliteal arteriovenous fistula and pseudoaneurysm formation are related to trauma. Few cases have previously been reported after acupuncture therapy. Such events are typically observed when the procedure is performed by non-medical acupuncturist. They may present with acute ischemia, recent claudication, distal emboli, or less commonly rupture. Duplex ultrasound should be considered as the 1st method of investigation. Computed tomography scanning is particularly accurate in making the diagnosis. Treatment strategies consist of surgery or endovascular management. The most commonly performed surgical technique for popliteal pseudoaneurysm repair is resection with bypass grafting, whereas popliteal arteriovenous fistula are usually treated surgically with ligation and primary repair. Endovascular procedure using a stent-graft is thought to be a reasonable option for treating popliteal false aneurysm or even arteriovenous fistula. We will describe two cases of an arteriovenous fistula and pseudoaneurysm of the popliteal artery that developed after acupuncture needling in the region of the popliteal artery.
Topics: Acupuncture Therapy; Adult; Aneurysm, False; Angiography; Arteriovenous Fistula; Humans; Male; Popliteal Artery; Ultrasonography, Doppler; Vascular Surgical Procedures
PubMed: 25623503
DOI: 10.1016/j.jmv.2014.11.001 -
Vascular Feb 2022Cases of arteriovenous fistula following iliac vein thrombosis are uncommon. The pathogenesis of its formation remains unclear. We present the efficacy of left common...
OBJECTIVES
Cases of arteriovenous fistula following iliac vein thrombosis are uncommon. The pathogenesis of its formation remains unclear. We present the efficacy of left common iliac vein recanalization in acquired arteriovenous fistula treatment.
METHODS
A 71-year-old man presented with severe lower left limb edema and was diagnosed with acquired arteriovenous fistula following iliac vein thrombosis. Treatment by recanalizing the left common iliac vein with bare stents was selected over embolizing the arteriovenous fistula, leading to an excellent clinical outcome.: Acquired arteriovenous fistula should be considered in some patients with post-thrombotic syndrome. Endovascular recanalization without embolization of the arteriovenous fistula can effectively treat iliac vein thrombosis associated with arteriovenous fistula.
Topics: Aged; Aneurysm; Arteriovenous Fistula; Humans; Iliac Artery; Iliac Vein; Male; Stents; Treatment Outcome; Venous Thrombosis
PubMed: 33761810
DOI: 10.1177/1708538121995298