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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 -
Kidney360 Jan 2021
Topics: Arteriovenous Fistula; Arteriovenous Shunt, Surgical; Humans; Kidney Diseases; Renal Dialysis
PubMed: 35368825
DOI: 10.34067/KID.0006262020 -
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 -
The Journal of Vascular Access May 2021Iatrogenic arteriovenous fistula of major neck vessels is a rare complication but can occur after central venous catheterization. Symptoms can range from nothing to...
Iatrogenic arteriovenous fistula of major neck vessels is a rare complication but can occur after central venous catheterization. Symptoms can range from nothing to severe heart failure and management can be particularly complex. We report a case that we treated recently in our department.
Topics: Aged; Arteriovenous Fistula; Catheterization, Central Venous; Humans; Iatrogenic Disease; Jugular Veins; Ligation; Male; Subclavian Artery; Treatment Outcome; Vascular Surgical Procedures; Vascular System Injuries
PubMed: 32425097
DOI: 10.1177/1129729820923920 -
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 -
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 -
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 -
High-flow arteriovenous fistula and hemodynamic consequences at 1 year after kidney transplantation.Seminars in Dialysis Mar 2022There are only scarce data regarding the cardiovascular impact of arteriovenous fistula after kidney transplantation depending on fistula flow.
INTRODUCTION
There are only scarce data regarding the cardiovascular impact of arteriovenous fistula after kidney transplantation depending on fistula flow.
METHODS
We performed a single-center, prospective, cohort study including 49 patients with a functional fistula at 1 year from kidney transplantation. Patients were convened for a clinical work-up, a biological analysis, a fistula's Doppler ultrasonography and an echocardiography. Main judgment criterion was comparison of echocardiography parameters between patients with relative (fistula flow >1 L/min and a fistula flow/cardiac output ratio >20%), absolute high-flow fistula (fistula flow >2 L/min) and normal-flow fistula.
RESULTS
High-flow fistula frequency was 69%. Significantly higher left ventricular end-diastolic and systolic diameters were observed in this group compared with the normal-flow fistula group (53 ± 6 vs. 48 ± 7 mm; p = 0.04 and 33 ± 6 vs. 28 ± 8 mm; p = 0.02) and between the absolute and relative high-flow fistula subgroups (56 ± 6 vs. 51 ± 6 mm; p = 0.009 and 35 ± 6 vs. 31 ± 5 mm; p = 0.01). The study showed no other significant differences.
CONCLUSIONS
This study showed a significantly higher but not pathological left ventricular end-diastolic and systolic diameters values in patients with high-flow fistula compared with patients with normal-flow fistula and between patients with respectively absolute and relative high-flow fistula.
Topics: Arteriovenous Fistula; Arteriovenous Shunt, Surgical; Cohort Studies; Hemodynamics; Humans; Kidney Transplantation; Prospective Studies; Renal Dialysis
PubMed: 34726295
DOI: 10.1111/sdi.13028