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CNS Neuroscience & Therapeutics Oct 2019Patients with brain arteriovenous malformation (bAVM) are at risk of intracranial hemorrhage (ICH). Overall, bAVM accounts for 25% of hemorrhagic strokes in adults... (Review)
Review
Patients with brain arteriovenous malformation (bAVM) are at risk of intracranial hemorrhage (ICH). Overall, bAVM accounts for 25% of hemorrhagic strokes in adults <50 years of age. The treatment of unruptured bAVMs has become controversial, because the natural history of these patients may be less morbid than invasive therapies. Available treatments include observation, surgical resection, endovascular embolization, stereotactic radiosurgery, or combination thereof. Knowing the risk factors for bAVM hemorrhage is crucial for selecting appropriate therapeutic strategies. In this review, we discussed several biological risk factors, which may contribute to bAVM hemorrhage.
Topics: Arteriovenous Fistula; Blood-Brain Barrier; Embolization, Therapeutic; Humans; Intracranial Arteriovenous Malformations; Intracranial Hemorrhages; Radiosurgery; Risk Factors; Vascular Endothelial Growth Factor A
PubMed: 31359618
DOI: 10.1111/cns.13200 -
Fertility and Sterility Oct 2021To quantify the efficacy of medical management of uterine arteriovenous malformation (AVM) and compare efficacy between different classes of medication. In addition, we... (Comparative Study)
Comparative Study Meta-Analysis
OBJECTIVE
To quantify the efficacy of medical management of uterine arteriovenous malformation (AVM) and compare efficacy between different classes of medication. In addition, we evaluated for factors associated with treatment success and pregnancy outcomes after medical management.
DESIGN
Systematic review and meta-analysis.
SETTING
Not applicable.
PATIENT(S)
Thirty-two studies representing 121 premenopausal women with medically-treated uterine AVM were identified via database searches of MEDLINE, Embase, Web of Science, and cited references.
INTERVENTION(S)
Medical treatment with progestins, gonadotropin-releasing hormone agonists (GnRH-a), methotrexate, combined hormonal contraception , uterotonics, danazol, or combination of the above.
MAIN OUTCOME MEASURE(S)
Primary outcome of treatment success was defined as AVM resolution without subsequent procedural interventions. Secondary outcome was treatment complication (readmission or transfusion).
RESULT(S)
The overall success rate of medical management was 88% (106/121). After adjusting for clustering effects, success rates for progestin (82.5%; 95% confidence interval [CI], 70.1%-90.4%), GnRH-a (89.3%; 99% CI, 71.4%-96.5%) and methotrexate (90.0%; 99% CI, 55.8%-98.8%) were significantly different from the null hypothesis of 50% success. The agents with the lowest adjusted proportion of complications were progestins (10.0%; 99% CI, 3.3%-26.8%) and GnRH-a (10.7%; 99% CI, 3.5%-28.4%). No clinical factors were found to predict treatment success. Twenty-six subsequent pregnancies are described, with no reported recurrences of AVM.
CONCLUSION(S)
Medical management for uterine AVM is a reasonable approach in a well selected patient. These data should be interpreted in the context of significant publication bias.
Topics: Arteriovenous Fistula; Blood Transfusion; Clinical Decision-Making; Female; Humans; Patient Readmission; Patient Selection; Pregnancy; Pregnancy Rate; Risk Assessment; Risk Factors; Treatment Outcome; Uterine Artery; Uterus
PubMed: 34130801
DOI: 10.1016/j.fertnstert.2021.05.095 -
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 -
Kidney360 Jan 2021
Topics: Arteriovenous Fistula; Arteriovenous Shunt, Surgical; Humans; Kidney Diseases; Renal Dialysis
PubMed: 35368825
DOI: 10.34067/KID.0006262020 -
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 -
Laeknabladid Apr 2023The common femoral artery is a widely used for access in endovascular interventions. Various complications, such as hematoma, pseudoaneurysm and AV-fistula (AVF), can...
The common femoral artery is a widely used for access in endovascular interventions. Various complications, such as hematoma, pseudoaneurysm and AV-fistula (AVF), can arise from arterial punctures with estimated prevalence between 1-10%. AVF is a rare complication with prevalence p<1%. AVF can cause a hemodynamic change in the form of a arteriovenous shunt (AV-shunt). AV-shunts in the groin are usually small and asymptomatic but tend to be symptomatic with larger and persistent AVFs which can present with leg claudication or high outpute heart failure.
Topics: Humans; Arteriovenous Fistula; Punctures
PubMed: 36988132
DOI: 10.17992/lbl.2023.04.740 -
Journal of the American Society of... Nov 2018
Topics: Arteriovenous Fistula; Arteriovenous Shunt, Surgical; Humans; Renal Dialysis
PubMed: 30305311
DOI: 10.1681/ASN.2018090922 -
Clinical Journal of the American... Sep 2018
Topics: Arteriovenous Fistula; Arteriovenous Shunt, Surgical; Humans; Hyperplasia; Renal Dialysis
PubMed: 30139805
DOI: 10.2215/CJN.08860718 -
Korean Journal of Radiology Feb 2022Pulmonary arteriovenous malformation (AVM) is a congenital vascular disease in which interventional radiologists can play both diagnostic and therapeutic roles in... (Review)
Review
Pulmonary arteriovenous malformation (AVM) is a congenital vascular disease in which interventional radiologists can play both diagnostic and therapeutic roles in patient management. The diagnosis of pulmonary AVM is simple and can usually be made based on CT images. Endovascular treatment, that is, selective embolization of the pulmonary artery feeding the nidus of the pulmonary AVM, and/or selectively either the nidus or draining vein, has become a first-line treatment with advances in interventional devices. However, some vascular diseases can simulate pulmonary AVMs on CT and pulmonary angiography. This subset can confuse interventional radiologists and referring physicians. Vascular mimickers of pulmonary AVM have not been widely known and described in detail in the literature, although some of these require surgical correction, while others require regular follow-up. This article reviews the clinical and radiologic features of pulmonary AVMs and their mimickers.
Topics: Arteriovenous Fistula; Embolization, Therapeutic; Humans; Intracranial Arteriovenous Malformations; Pulmonary Artery; Pulmonary Veins
PubMed: 35029077
DOI: 10.3348/kjr.2021.0417 -
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