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1.
BMC Surg ; 21(1): 101, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622276

RESUMO

BACKGROUND: A pulmonary arteriovenous fistula (PAVF) is a rare condition that is associated with pulmonary arteriovenous malformation (PAVM). Few reports have described managing PAVMs using uniportal video-assisted thoracoscopic surgery (VATS). CASE PRESENTATION: A 13-year-old child with PAVF in the left inferior pulmonary artery was treated by uniportal VATS with left lower lobectomy. After surgery, hemoptysis did not recur and there were no postoperative complications. Six months after the operation, postoperative review of computerized tomography showed no recrudescence of PAVF. CONCLUSIONS: PAVF is a rare case that should be diagnosed and treated early. 3D- computerized tomography (CT) reconstruction is useful for diagnosis and preoperative assessment. The case shows that PAVF can be managed with uniportal VATS.


Assuntos
Fístula Arteriovenosa , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Cirurgia Torácica Vídeoassistida , Adolescente , Fístula Arteriovenosa/cirurgia , Humanos , Artéria Pulmonar/cirurgia , Veias Pulmonares/cirurgia , Cirurgia Torácica Vídeoassistida/métodos
3.
Zhonghua Yi Xue Za Zhi ; 101(6): 416-420, 2021 Feb 09.
Artigo em Chinês | MEDLINE | ID: mdl-33611891

RESUMO

Objective: To summarize the clinical effect of ultrasound-guided percutaneous transluminal angioplasty (PTA) in the treatment of arteriovenous fistula (AVF) immaturation under day surgery mode. Methods: The clinical data was retrospective analyzed of patients with AVF immaturation who were treated by ultrasound-guided PTA under day surgery mode from November 2016 to June 2019 in Renji Hospital. The basic information, lesion location, puncture approach, number and diameter of balloon used were counted. The primary and secondary patency rates were calculated at 6 and 12 months after operation. Results: In all of the 21 patients, 11 patients were male and 10 patients were female. The mean age was (52.6±12.9) years old. There were 20 of the 21 patients who were treated successfully. One patient had AVF reconstruction with vascular rupture, and the complication rate was 4.8% (1/21). The length of hospitalization was (1.05±0.71) days, and the cost was (11 487.7±4 401.4) yuan. The follow-up time was (19.7±8.3) months. The 6-month and 12-month primary patency rate were 70% and 55%, and the 6-month and 12-month secondary patency rate were both 90%. Conclusion: Ultrasound-guided PTA in the treatment of AVF immaturation under day surgery mode is safe and effective, which has a high technical success rate and good patency rate for AVF maturation.


Assuntos
Angioplastia com Balão , Fístula Arteriovenosa , Derivação Arteriovenosa Cirúrgica , Adulto , Idoso , Procedimentos Cirúrgicos Ambulatórios , Angioplastia , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/terapia , Feminino , Oclusão de Enxerto Vascular , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Renal , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia de Intervenção , Grau de Desobstrução Vascular
4.
No Shinkei Geka ; 49(1): 199-203, 2021 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-33494067

RESUMO

INTRODUCTION: Although arteriovenous fistulas(AVFs)are typically located within the cranium, there are several published reports documenting rare cases of extracranial AVFs between the ascending pharyngeal artery(APA)and the internal jugular vein(IJV). Herein, we report the case of a patient with APA-IJV AVFs who presented with symptoms of lower cranial nerve palsy that was treated with transvenous embolization(TVE). CASE: A 53-year-old man presented with chief complaints of numbness in the left oral cavity and a temple headache. Magnetic resonance angiography showed an abnormal signal in the left jugular bulb. An AVF was suspected; digital subtraction angiography revealed the presence of a shunt from the jugular branch of the APA to the jugular bulb which was accompanied by regurgitation into the inferior petrosal sinus(IPS)and sigmoid sinus(SS). Numbness in the oral cavity was diagnosed as lower cranial nerve palsy associated with increased pressure within the jugular foramen. As the nature of the AVF(single or multi-hole)was uncertain, a therapeutic TVE was planned. Microcatheters were guided into the IPS and SS, and TVE was performed using a double-catheter technique. Regurgitation into the IPS resolved; embolization via the APA was not performed, and symptoms improved postoperatively. CONCLUSIONS: AVFs involving the APA and IJV are identified infrequently and there are only a few published case reports describing this vascular anomaly. Most reported cases were single-hole AVF and were treated with trans-arterial embolization via the APA. As noted in the present case, APA-IJV AVF can also be treated by TVE.


Assuntos
Fístula Arteriovenosa , Malformações Vasculares do Sistema Nervoso Central , Doenças dos Nervos Cranianos , Embolização Terapêutica , Angiografia Digital , Fístula Arteriovenosa/terapia , Malformações Vasculares do Sistema Nervoso Central/terapia , Cavidades Cranianas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade
5.
Medicine (Baltimore) ; 100(1): e24215, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429814

RESUMO

RATIONALE: Traumatic arteriovenous fistulas (AVFs) of the pelvis are uncommon and present with a variety of clinical manifestations; their detection may be difficult. An endovascular approach is usually the first choice of treatment, because surgical intervention is complicated due to the location of the lesions. PATIENT CONCERNS: A 68-year-old man was admitted with severe pelvic pain following a fall. DIAGNOSIS: A pelvic bone fracture (Young and Burgess Classification, lateral compression type II) was revealed on pelvic computed tomography (CT), while a pelvic sidewall hematoma, unaccompanied by any vascular injury, was detected on multidetector CT. INTERVENTIONS: Pelvic angiography revealed an AVF between the internal iliac artery and vein, which was undetected by MDCT. The AVF was successfully treated using transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA). OUTCOMES: The patient recovered well and was discharged 4 weeks later. No complications were noted at the 8-month follow-up. LESSONS: AVF may occur as a complication of blunt pelvic bone fracture. A high index of suspicion, angiography, and prompt diagnosis resulted in the successful management of our patient who presented with risk factors. Furthermore, TAE using NBCA enables a minimally invasive and effective treatment of traumatic pelvic AVF.


Assuntos
Fístula Arteriovenosa/terapia , Embucrilato/uso terapêutico , Fraturas Ósseas/complicações , Ossos Pélvicos/lesões , Acidentes por Quedas , Idoso , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Angiografia por Tomografia Computadorizada , Embolização Terapêutica , Embucrilato/administração & dosagem , Fraturas Ósseas/diagnóstico por imagem , Humanos , Artéria Ilíaca , Veia Ilíaca , Masculino , Procedimentos Cirúrgicos Vasculares
6.
Vasc Endovascular Surg ; 55(1): 91-94, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32875955

RESUMO

Spontaneous ilio-iliac arteriovenous fistula (AVF) associated with aneurysms affecting the abdominal aortic and iliac arteries is a rare condition. The classical clinical symptoms of ilio-iliac AVF include high-output heart failure, abdominal pain, abdominal bruits and thrills, a pulsatile abdominal mass, and venous congestion symptoms (leg edema and hematuria). The prompt repair of AVF is necessary to restore the patient's hemodynamics. We report a case in which a patient with aneurysms affecting the abdominal aortic and iliac arteries and an ilio-iliac AVF presented with high-output heart failure and leg ischemia and was successfully treated via endovascular stent graft repair.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Fístula Arteriovenosa/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Aneurisma Ilíaco/cirurgia , Artéria Ilíaca/cirurgia , Veia Ilíaca/cirurgia , Idoso , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/fisiopatologia , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/fisiopatologia , Prótese Vascular , Implante de Prótese Vascular/instrumentação , Procedimentos Endovasculares/instrumentação , Humanos , Aneurisma Ilíaco/diagnóstico por imagem , Aneurisma Ilíaco/fisiopatologia , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/fisiopatologia , Veia Ilíaca/diagnóstico por imagem , Veia Ilíaca/fisiopatologia , Masculino , Stents , Resultado do Tratamento
8.
Rev Fac Cien Med Univ Nac Cordoba ; 77(4): 356-359, 2020 12 19.
Artigo em Espanhol | MEDLINE | ID: mdl-33351370

RESUMO

Introduction: Congenital renal arteriovenous fistula is an abnormal connection between the arterial and venous system. Since the first case described in 1928 by Varela et al, no more than 200 cases have been published. Material and methods: A 45-year-old woman consulted for severe abdominal and low-back pain associated with arterial hypertension. The CT scan showed an infrarenal retroperitoneal lesion with invasion of neighboring structures. Results: During the abdominal exploration, a vascular-looking lesion of 60 x 34 x 41 mm was identified. It was associated with right nephrectomy. Discussion: The etiology of congenital fistulas remains unknown; it is believed that a congenital arterial aneurysm erodes into an adjacent vein and gradually increases its size. Other authors believe that the fistula exists since birth and gradually increases its size until it causes symptoms. Conclusion: Congenital arteriovenous fistulas are rare entities, representing less than 25% of all renal arteriovenous malformations.


Assuntos
Abdome Agudo , Fístula Arteriovenosa , Aneurisma , Fístula Arteriovenosa/complicações , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/cirurgia , Feminino , Humanos , Rim/diagnóstico por imagem , Pessoa de Meia-Idade , Artéria Renal/diagnóstico por imagem
9.
Praxis (Bern 1994) ; 109(15): 1205-1209, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33234040

RESUMO

Not Another Arm Vein Thrombosis - Memories of the Past Abstract. This article points out relevant differential diagnoses of a unilateral arm swelling that is a key clinical sign of an upper extremity vein thrombosis. The presented case is a patient with a symptomatic, iatrogenic arteriovenous fistula between the subclavian artery and vein due to central venous port system implantation.


Assuntos
Fístula Arteriovenosa , Trombose , Trombose Venosa , Idoso , Braço , Humanos , Veia Subclávia/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem
10.
Medicine (Baltimore) ; 99(42): e22819, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080760

RESUMO

INTRODUCTION: Pial arteriovenous fistula (PAVF) is a rare intracranial vascular disease, and its presentation with a huge tumor-resembling thrombus is rarer. PATIENT CONCERNS: A 38-year-old female patient presented with a sudden left-side motor disorder and loss of consciousness. The patient was otherwise in good health and had no history of hypertension or diabetes. During the physical examination, she appeared lethargic and manifested left limb paralysis with level zero muscle strength and a positive pathological reflex. DIAGNOSES: Because imaging failed to rule out a tumor stroke, an intracranial lesion resection was performed immediately. Because the lesion was considered to be a vascular structure, digital subtraction angiography was undertaken before the surgery, and PAVF was diagnosed. INTERVENTIONS: Endovascular embolization was conducted, followed by PAVF and hematoma resection. OUTCOMES: At the 3-month follow up, her left limb muscle strength was level 4, and she could live on her own (Modified Rankin Scale score = 2). CONCLUSIONS: It is noteworthy that PAVF with a large thrombus may appear as a tumor in the initial diagnosis, and therefore it is necessary to perform an intracranial vascular examination in patients with tumor stroke symptoms.


Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/patologia , Pia-Máter/irrigação sanguínea , Pia-Máter/diagnóstico por imagem , Adulto , Angiografia Digital , Feminino , Hematoma Subdural Intracraniano/diagnóstico por imagem , Hematoma Subdural Intracraniano/patologia , Humanos , Trombose Intracraniana/diagnóstico por imagem , Trombose Intracraniana/patologia , Imagem por Ressonância Magnética , Pia-Máter/patologia , Tomografia Computadorizada por Raios X
11.
Artigo em Russo | MEDLINE | ID: mdl-33081455

RESUMO

Paradoxical embolism is one of the mechanisms of ischemic stroke in patients younger than 45 years of age, due to opening between the right and left chambers of the heart through a patent foramen ovale, an atrial or ventricular septal defect, pulmonary arteriovenous malformations (PAVMs), etc. The PAVMs are structurally abnormal vessels that provide direct capillary-free communication between the pulmonary and systemic circulations, and hence an anatomic "right-to-left" shunt. Most pulmonary malformations are congenital and associated with hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease). This publication highlights the issues of pathogenesis, clinical presentation, diagnosis and treatment of this pathology, and also describes a clinical case in which multiple PAVMs caused repeated ischemic strokes.


Assuntos
Fístula Arteriovenosa , Embolia Paradoxal , Veias Pulmonares , Acidente Vascular Cerebral , Fístula Arteriovenosa/complicações , Fístula Arteriovenosa/diagnóstico por imagem , Embolia Paradoxal/diagnóstico por imagem , Embolia Paradoxal/etiologia , Humanos , Artéria Pulmonar/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia
12.
J Cardiothorac Surg ; 15(1): 290, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008483

RESUMO

BACKGROUND: Pulmonary arteriovenous malformations are uncommon conditions of abnormal communications between pulmonary arteries and veins, which are most commonly congenital in nature. Although such condition is not extremely rare, it is a challenge to the differential diagnosis of pulmonary problems such as hypoxemia and pulmonary lesions. CASE PRESENTATION: We report a meaningful case of a 23-year-old male presented with elevated hemoglobin (23.0 g/dl) on admission. Physical examination revealed cyanosis, digital clubbing and low oxygen saturation on room air. The patient was initially diagnosed as polycythemia vera while the subsequent result of bone marrow aspiration was negative. During further assessment, pulmonary arteriovenous malformations were detected by CT pulmonary angiography. Lobectomy was successfully performed with significant increase in oxygen saturation from 86 to 98%. The hemoglobin decreased to almost normal level of 14.9 g/dl 3 months after surgery and the patient had been followed up for nearly 5 years. CONCLUSIONS: Pulmonary arteriovenous malformations should be suspected in patients with central cyanosis, digital clubbing, polycythemia, pulmonary lesion and without cardiac malformations. Embolization or surgery is strongly recommended to reduce the risks caused by pulmonary arteriovenous malformations.


Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/cirurgia , Artéria Pulmonar/anormalidades , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Veias Pulmonares/anormalidades , Tuberculose/complicações , Fístula Arteriovenosa/complicações , Angiografia por Tomografia Computadorizada , Progressão da Doença , Humanos , Masculino , Pneumonectomia , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/cirurgia , Adulto Jovem
15.
Enferm. clín. (Ed. impr.) ; 30(5): 317-325, sept.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-196774

RESUMO

OBJETIVO: Validar el contenido del guion de un video educativo para promover el autocuidado de la fístula arteriovenosa en los pacientes renales crónicos, con enfermeras y comunicadores sociales. MÉTODO: Estudio metodológico que construyó y validó un video educativo. En primer lugar, las demandas de autocuidado se identificaron por medio de una revisión de la literatura sobre autocuidado con fístula arteriovenosa. A continuación, la construcción del video siguió los pasos de preproducción, producción y posproducción. La validación del contenido del video ocurrió en la fase de preproducción y contó con 22 jueces de enfermería y profesionales de los medios. El estudio fue aprobado por el Comité de Ética en Investigación, bajo el Certificado de ética: 61705516.0.0000.5208. RESULTADOS: Los siguientes ítems presentaron una evaluación negativa de los jueces: las escenas descritas reflejan estereotipos o discriminación (p = 0,008), el ritmo de las escenas es agotador (p = 0,001/p = 0,034), los personajes/imágenes son atractivos para el público (p = 0,006), las ilustraciones reflejan aspectos importantes del tema en el estudio (p = 0,006), las ilustraciones motivan la comprensión del mensaje de video (p = 0,001) y la estructura general es creativa (p = 0,001). CONCLUSIÓN: El video educativo fue considerado válido por jueces de enfermería y profesionales de los medios de comunicación, para promover el autocuidado de la fístula arteriovenosa en pacientes renales


OBJECTIVE: To validate the content of the script of an educational video to promote self-care with arteriovenous fistula in chronic renal patients with nurses and social communicators. METHOD: Methodological study that constructed and validated an educational video. Firstly, the demands of self-care were identified through a literature review on self-care with arteriovenous fistula. Then the construction of the video followed the steps of pre-production, production and post-production. The script's content validation occurred in the pre-production phase and counted on 22 nursing judges and media professionals. The study was approved by the Ethics Committee in Research, under opinion 61705516.0.0000.5208. RESULTS: The following items received a negative evaluation from the judges: "The scenes described reflect stereotypes or discrimination" (p = 0.008) and "The pace of the scenes is tiring" (p = 0.001/p = 0.034), "The characters/images are appealing to the audience (p = 0.006), "The illustrations reflect important aspects of subject under study" (p = 0.006), "The illustrations promote the understanding of the video message" (p = 0.001) and "The general structure is creative" (p = 0.001). CONCLUSION: The educational video was considered valid by the nursing judges and media professionals to promote self-care with arteriovenous fistula among renal patients


Assuntos
Humanos , Gravação em Vídeo/métodos , Autocuidado/métodos , Fístula Arteriovenosa/enfermagem , Educação de Pacientes como Assunto/métodos , Insuficiência Renal Crônica/enfermagem , Falência Renal Crônica/enfermagem , Falência Renal Crônica/terapia
18.
Stroke ; 51(10): 2990-2996, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912090

RESUMO

BACKGROUND AND PURPOSE: Do children have an increased risk for brain arteriovenous malformation (AVM) recurrence compared with adults and does this risk vary depending on initial presentation with AVM rupture? METHODS: We retrospectively studied 115 patients initially presenting with brain AVM under age 25 years who underwent complete surgical resection of the AVM as documented by digital subtraction angiography (DSA) and had delayed follow-up DSA to evaluate for AVM recurrence after apparent initial cure. RESULTS: The mean time from baseline DSA to follow-up DSA was 2.3 years, ranging from 0 to 15 years. Twelve patients (10.4% of the 115 patient cohort and 16.7% of 72 patients with hemorrhage at initial presentation) demonstrated AVM recurrence on follow-up DSA. All patients with recurrence initially presented with intracranial hemorrhage, and intracranial hemorrhage was a significant predictor of recurrence (log rank P=0.037). Among patients with initial hemorrhage, the 5-year recurrence rate was 17.8% (95% CI, 8.3%-35.7%). All recurrences occurred in patients who were children at the time of their initial presentation; the oldest was 15 years of age at the time of initial AVM surgery. The 5-year recurrence rate for children (0-18 years of age) with an initial presentation of hemorrhage was 21.4% (95% CI, 10.1%-41.9%). Using Cox regression, we found the risk of AVM recurrence decreased by 14% per each year increase in age at the time of initial surgical resection (hazard ratio=0.86 [95% CI, 0.75-0.99]; P=0.031). CONCLUSIONS: There is a high rate of recurrence of apparently cured brain AVMs in children who initially present with AVM rupture. Imaging follow-up is warranted to prevent re-rupture.


Assuntos
Fístula Arteriovenosa/cirurgia , Encéfalo/cirurgia , Malformações Arteriovenosas Intracranianas/cirurgia , Adolescente , Angiografia Digital , Fístula Arteriovenosa/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Masculino , Microcirurgia , Procedimentos Neurocirúrgicos , Recidiva , Estudos Retrospectivos , Ruptura/cirurgia , Resultado do Tratamento , Adulto Jovem
19.
PLoS One ; 15(9): e0238788, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32991608

RESUMO

OBJECTIVES: To evaluate the efficacy and long-term patency of endovascular treatment for non-maturing native arteriovenous fistulas according to the approach route (arterial vs. venous). METHODS: Eighty-five patients underwent percutaneous transluminal angioplasty for non-maturing fistulas (63 radiocephalic and 22 brachiocephalic) between 2010 and 2019. Outcome variables such as procedural success, complications, and primary and secondary patency rates were analyzed from the patients' demographic, angiographic, clinical, and hemodialysis records according to the approach route (venous access group, n = 53 and arterial access group, n = 32). The Kaplan-Meier method was used to analyze the patency rates. RESULTS: The mean duration from fistula creation to fistulography was 78.4±51.4 days (range, 1-180 days). The anatomical and clinical success rates were 98.8% and 83.5%, respectively. Lesions were most commonly located at the juxta-anastomosis (55.3%). Accessory cephalic veins were observed in 16 patients. The primary patency rates were 83.9%, 71.9%, and 66.3% and the secondary patency rates were 98.6%, 95.9%, and 94.2% at 3 months, 6 months, and 1 year, respectively. The degree of hypertension (P = 0.023), minimal preoperative vein size (P = 0.041), and increment in postoperative vein diameter were higher in the venous access group than in the arterial access group (P<0.01). The frequency of using cutting balloons (P = 0.026) and complication rate were higher in the arterial access group than in the venous access group (arterial access: 1 major, 8 minor; venous access: 4 minor; P = 0.015). CONCLUSIONS: Aggressive evaluation and endovascular therapy can salvage most non-maturing fistulas. Transradial and distal radial approaches can be effective even for challenging lesions.


Assuntos
Angioplastia/métodos , Fístula Arteriovenosa/complicações , Veias/fisiopatologia , Idoso , Angiografia , Angioplastia/efeitos adversos , Angioplastia com Balão/efeitos adversos , Angioplastia com Balão/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Terapia de Salvação/métodos , Resultado do Tratamento
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