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4.
Arch. argent. pediatr ; 119(3): 152-161, Junio 2021. tab, ilus
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1222429

RESUMO

Introducción. Las malformaciones vasculares cerebrales de alto flujo son poco comunes en la edad pediátrica. El objetivo del trabajo es diferenciar y agrupar estas enfermedades según edad de debut, manifestaciones clínicas y angioarquitectura.Población y método. Se realizó un estudio retrospectivo y observacional. Se analizaron las historias clínicas, los estudios por imágenes y los protocolos de procedimientos de pacientes del Hospital J. P. Garrahan con diagnóstico de malformaciones vasculares cerebrales desde enero de 2010 hasta enero de 2020.Resultados. Ciento ochenta y tres pacientes cumplieron los criterios de inclusión. Se identificaron 131 pacientes con malformaciones arteriovenosas con nido (MAV) y 52 con fístulas directas (sin nido), entre los que se hallaron 19 malformaciones aneurismáticas de vena de Galeno, 23 fístulas piales y 10 fístulas durales. La edad promedio fue de 105 meses para las MAV, 1,7 meses para las malformaciones aneurismáticas de vena de Galeno, 60,5 meses para fístulas piales y 41 meses para fístulas durales.Conclusión. Según su angioarquitectura, las malformaciones vasculares cerebrales de alto flujo tuvieron nido (MAV) o fueron fístulas directas (malformaciones aneurismáticas de vena de Galeno, fístulas piales y fístulas durales). Las MAV se manifestaron a partir de la primera infancia, sobre todo, por hemorragia intracraneana. Las fístulas directas se expresaron en la primera etapa de la vida, frecuentemente, con insuficiencia cardíaca.


Introduction. High-flow vascular malformations of the brain are uncommon in pediatrics. The objective of this study is to establish the differences among these pathologies and group them by age at onset, clinical manifestations, and angioarchitecture.Population and method. This was a retrospective and observational study. The medical records, imaging studies, and procedure protocols of patients seen at Hospital J. P. Garrahan diagnosed with vascular malformations of the brain between January 2010 and January 2020 were analyzed.Results. A total of 183 patients met the inclusion criteria. It was possible to identify 131 patients with arteriovenous malformations with a nidus (AVMs) and 52 with direct fistulas (without a nidus), including 19 vein of Galen aneurysmal malformations, 23 pial fistulas, and 10 dural fistulas. The average age of patients was 105 months for AVMs, 1.7 months for vein of Galen aneurysmal malformations, 60.5 months for pial fistulas, and 41 months for dural fistulas.Conclusion. Based on their angioarchitecture, high-flow vascular malformations of the brain presented a nidus (AVMs) or direct fistulas (vein of Galen aneurysmal malformations, pial fistulas, and dural fistulas). AVMs were observed in early childhood, especially due to intracranial hemorrhage. Direct fistulas occurred in the first stage of life, commonly with heart failure.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Malformações Arteriovenosas/terapia , Malformações Arteriovenosas/diagnóstico por imagem , Estudos Retrospectivos , Fístula Arteriovenosa/terapia , Fístula Arteriovenosa/diagnóstico por imagem , Hemorragias Intracranianas , Malformações da Veia de Galeno/terapia , Malformações da Veia de Galeno/diagnóstico por imagem , Insuficiência Cardíaca
5.
No Shinkei Geka ; 49(3): 665-676, 2021 May.
Artigo em Japonês | MEDLINE | ID: mdl-34092573

RESUMO

In this paper, we outlined the diagnostic and treatment strategies for spinal arteriovenous malformations, focusing on dural and perimedullary arteriovenous fistula(AVF). In many patients with spinal arteriovenous malformations, the symptoms are non-specific. Therefore, we consider it is critical to detect the signal flow voids in the enlarged spinal veins using MRI. An accurate understanding of the vascular structures is indispensable for deciding appropriate treatment strategies. Hence, performing an angiography is essential. Regarding treatment, whether to select surgical or endovascular treatment for AVF depends largely on the institution's protocols. However, the treatment should always be based on an accurate diagnosis.


Assuntos
Fístula Arteriovenosa , Malformações Arteriovenosas , Malformações Vasculares do Sistema Nervoso Central , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/cirurgia , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/cirurgia , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Malformações Vasculares do Sistema Nervoso Central/cirurgia , Humanos , Imageamento por Ressonância Magnética , Medula Espinal/cirurgia
6.
Br J Radiol ; 94(1123): 20200695, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34038182

RESUMO

Pulmonary arteriovenous malformations (PAVM) are abnormal communication of a branch of the pulmonary artery and pulmonary vein circumventing the intervening pulmonary capillaries. This results in a right-to-left (R-L) shunt and its related manifestations, which include hampered gas exchange leading to hypoxaemia, dyspnoea, paradoxical emboli leading to stroke, cerebral abscess, myocardial infarction and pulmonary haemorrhage due to rupture of the PAVM. Endovascular transcatheter embolization of the feeding vessels with coils or occlusion devices is the current standard care of treatment and preferred treatment modality. The articles aim to provide insights into the current trends in diagnosis, the current recommendations, approach and management options for patients with PAVM.


Assuntos
Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Procedimentos Endovasculares , Artéria Pulmonar/anormalidades , Veias Pulmonares/anormalidades , Embolização Terapêutica , Humanos
7.
A A Pract ; 15(6): e01481, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34043592

RESUMO

A pregnant woman with large intraoral arteriovenous malformation of tongue obliterating the oral cavity presented for elective cesarean delivery shortly after experiencing spontaneous, large-volume, oral bleeding. This case report describes the unconventional method of securing the airway for ensuring perioperative airway protection and the anesthetic management of the case.


Assuntos
Anestesia Obstétrica , Anestésicos , Malformações Arteriovenosas , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/cirurgia , Cesárea , Feminino , Humanos , Gravidez , Língua/cirurgia
8.
BMJ Case Rep ; 14(5)2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34045203

RESUMO

Arteriovenous malformation (AVM) of the head and neck is a rare phenomenon, more so when it is an extracranial AVM like the auricle. AVMs are caused by genetic mutations. Most are probably present in the subclinical form at birth and then evolve; some may arise postnatally or during adolescence or get aggravated by precipitating factors like trauma, infection or hormonal influence like puberty or pregnancy. Once diagnosed, the feeding vessels have to be identified using radiological investigations. They are then embolised via means of percutaneous embolisation and surgical resection.


Assuntos
Malformações Arteriovenosas , Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Adolescente , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Orelha Externa , Feminino , Cabeça , Humanos , Recém-Nascido , Malformações Arteriovenosas Intracranianas/terapia , Pescoço , Gravidez
9.
J Int Med Res ; 49(5): 3000605211016381, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34024190

RESUMO

Renal arteriovenous malformations (AVMs) are infrequent vascular morphological anomalies. About 20% of AVMs are congenital renal AVMs (CRAVMs). A 53-year-old female patient presented with a 5-day history of gross hematuria and right flank pain. The patient underwent the selective renal arteriography and embolization under local anesthesia. Renal computed tomography angiography (CTA) and digital subtraction angiography (DSA) results showed bleeding of the right renal arteriovenous malformation, both nidus and aneurysm, which indicated that the patient had both cirsoid and cavernosal types of CRAVM. Endovascular management was chosen to treat the patient. The patient was cured and discharged, then followed-up for 3 months. These results show that early identification using radiologic tests is important for diagnosis and treatment of CRAVM.


Assuntos
Malformações Arteriovenosas , Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Nefropatias , Angiografia Digital , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/cirurgia , Feminino , Humanos , Rim/diagnóstico por imagem , Rim/cirurgia , Pessoa de Meia-Idade
10.
J Pak Med Assoc ; 71(3): 1020-1021, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34057969

RESUMO

Uterine arteriovenous malformation (AVM) is an uncommon but fatal condition and can cause bleeding from abnormal connection between artery and vein. Pregnancy after embolization of uterine AVM is very uncommon, and there are increased risks of spontaneous abortion and growth retardation. We report a case of pregnancy after bilateral uterine artery embolization for AVM and its successful outcome..


Assuntos
Aborto Espontâneo , Malformações Arteriovenosas , Embolização da Artéria Uterina , Artérias , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Feminino , Humanos , Gravidez , Útero
11.
BMJ Case Rep ; 14(4)2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33893134

RESUMO

We report a case of renal arteriovenous malformation (AVM) and describe its angioarchitecture and endovascular management. A 28-year-old male patient presented with visible painless haematuria. CT of the abdomen showed a right renal AVM. Digital subtraction angiography of the right renal vessels showed an AVM of middle and lower pole segmental arteries with communication to a large saccular aneurysm, which was arising from the right main renal vein. Complete occlusion of the AVM was done by using glue (a mixture of n-butyl-cyanoacrylate and lipiodol), resulting in nonvisualisation of the aneurysm on angiography. His vital signs were stable during the procedure. Follow-up CT after 12 months showed no residual flow in the aneurysm, normal upper pole renal parenchyma and nonvisualisation of AVM. Early diagnosis of this clinical entity is of paramount importance for proper management as it can cause massive blood loss and rapid clinical deterioration.


Assuntos
Malformações Arteriovenosas , Embolização Terapêutica , Embucrilato , Aneurisma Intracraniano , Malformações Arteriovenosas Intracranianas , Adulto , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Hematúria/etiologia , Humanos , Aneurisma Intracraniano/terapia , Malformações Arteriovenosas Intracranianas/terapia , Masculino
13.
J Med Case Rep ; 15(1): 177, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33785059

RESUMO

BACKGROUND: Heart failure is usually associated with a low-cardiac-output state; however, a minority of these patients are characterized by a high-output cardiac state, described as a cardiac index of > 4 L/minute/m2. Usually such circulation is associated with low systemic vascular resistance or arteriovenous malformation (AVM), resulting in depressurized circulation and a high-output cardiac state. Treating physicians should be cognizant of such pathology when investigating patients with heart failure. As an example, renal arteriovenous malformations are a rare vascular phenomena that are typically the result of iatrogenic, traumatic or congenital etiology. Generally, non-salient, most are detected as an incidental finding. CASE PRESENTATION: A 75-year-old Afro-Caribbean man with multiple comorbidities presented to the emergency department with a 6-month history of heart failure symptoms. Cardiac catheterization demonstrated a giant right renal AVM leading to a significant left-to-right, post-tricuspid shunt that was treated with transcatheter coiling. CONCLUSIONS: We present this case to emphasize the significance of a detailed workup in a patient with heart failure symptoms.


Assuntos
Malformações Arteriovenosas , Insuficiência Cardíaca , Hipertensão Pulmonar , Idoso , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico por imagem , Cateterismo Cardíaco , Coração , Insuficiência Cardíaca/etiologia , Humanos , Hipertensão Pulmonar/etiologia , Masculino
14.
BMJ Case Rep ; 14(3)2021 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-33692060

RESUMO

We present a rare case of single pulmonary arteriovenous malformation (PAVM) with multiple metal allergies, including for platinum. A 47-year-old woman presented to our hospital without any symptoms. Enhanced computed tomography showed a single PAVM in S6 of the right lung. Interviews prompted us to suspect a history of palmoplantar pustulosis associated with metal dental filling. Dermatology patch tests for metal allergy were positive for platinum, cobalt, tin and potassium dichromate. The first choice of treatment for PAVM is endovascular treatment using a metal coil. Since the coil is composed of platinum alloy, we performed partial lung resection for PAVM without metal implants. Although metal allergy is rare for endovascular treatment, it causes an additional stress of removal of causative metal or long-term steroidal treatment. Therefore, for single PAVM with multiple metal allergies to the implants, surgical treatment without metal implants should be considered.


Assuntos
Fístula Arteriovenosa , Malformações Arteriovenosas , Hipersensibilidade , Veias Pulmonares , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/cirurgia , Feminino , Humanos , Hipersensibilidade/etiologia , Pessoa de Meia-Idade , Artéria Pulmonar/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/cirurgia
15.
Ann R Coll Surg Engl ; 103(5): e173-e176, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33682460

RESUMO

Vascular arteriovenous malformations originate during the early stages of embryonic development and generally grow progressively, especially during adolescence and pregnancy. Limb salvage using microsurgery is presented, in a patient with an arteriovenous malformation who was initially a candidate for limb amputation. En bloc resection of the arteriovenous malformation of all segments with extended brachial approach and the cutaneous component was performed, with an anterolateral thigh free flap for the lateral reconstruction of the hand.


Assuntos
Malformações Arteriovenosas/cirurgia , Retalhos de Tecido Biológico/cirurgia , Deformidades Congênitas da Mão/cirurgia , Salvamento de Membro/métodos , Coxa da Perna/cirurgia , Adolescente , Malformações Arteriovenosas/diagnóstico por imagem , Feminino , Retalhos de Tecido Biológico/irrigação sanguínea , Mãos/irrigação sanguínea , Mãos/diagnóstico por imagem , Mãos/cirurgia , Deformidades Congênitas da Mão/diagnóstico por imagem , Humanos , Microcirurgia/métodos , Coxa da Perna/irrigação sanguínea
16.
S D Med ; 74(1): 14-16, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33691051

RESUMO

Uterine arteriovenous malformation (AVM) is a rare condition that is potentially life-threatening. There are limited published reports on this condition. This is a case report of a 25-year-old woman who presented with a symptomatic AVM. We review the differential diagnoses, evaluation, and treatment options. Conservative treatment with interventional radiology can be considered in select women who desire fertility preservation.


Assuntos
Malformações Arteriovenosas , Anormalidades Urogenitais , Embolização da Artéria Uterina , Adulto , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/terapia , Feminino , Humanos , Artéria Uterina , Útero/diagnóstico por imagem
20.
J Vet Intern Med ; 35(2): 1098-1104, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33527500

RESUMO

A 2-year-old crossbreed dog was presented for evaluation of a 6-week history of progressive paraparesis. Magnetic resonance imaging and computed tomography angiography of the thoracic and lumbar spinal cord disclosed multifocal, anomalous, small, vascular structures, distributed throughout the subarachnoid space of the included section of the spinal cord. An additional focal intramedullary lesion was identified extending from T9 to T10 to T12. Histopathological examination confirmed the presence of an intramedullary arteriovenous malformation affecting the thoracic spinal cord and leading to diffuse congestion and focal hemorrhages into the affected spinal cord.


Assuntos
Malformações Arteriovenosas , Doenças do Cão , Doenças da Medula Espinal , Angiografia , Animais , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/etiologia , Cães , Imageamento por Ressonância Magnética/veterinária , Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/etiologia , Doenças da Medula Espinal/veterinária
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