11/1789. Combined femoral pseudoaneurysm and arteriovenous fistula: diagnosis by Doppler color flow mapping.This case report is the first to describe a combined femoral pseudoaneurysm and arteriovenous fistula resulting from a cardiac catheterization, diagnosed by color Doppler.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
12/1789. Intrahepatic arterioportal fistula: gadolinium-enhanced 3D magnetic resonance angiography findings and angiographic embolization with steel coils.We describe a case of a 59-year-old patient with intrahepatic arterioportal fistula secondary to blunt trauma sustained by a motor vehicle accident 36 years earlier. The fistula was demonstrated 36 years after the accident in a clinical work-up for diarrhea of 1 month's duration, using contrast enhanced three-dimensional breath-hold MRA. A communication between the dilated portal vein and dilated hepatic artery was shown at the level of distal branches. After subsequent demonstration by conventional angiography, the fistula was embolized using steel coils. Following the therapeutic intervention, the patient's diarrhea ceased.- - - - - - - - - - ranking = 1.4keywords = fistula (Clic here for more details about this article) |
13/1789. A rare complication of renal biopsy in a child with membranoproliferative glomerulonephritis.Percutaneous renal biopsy is essential for the definitive diagnosis of chronic glomerulonephritis. Large arteriovenous fistula (AVF) which is a rare complication of native renal biopsy is generally diagnosed in the first weeks after the procedure. We present a childhood membranoproliferative glomerulonephritis case with an enormous AVF presenting with severe hypertension 15 months after the biopsy that was successfully embolized. In conclusion, AVF must be considered in children having chronic glomerulonephritides even if hypertension appears late after the renal biopsy.- - - - - - - - - - ranking = 0.2keywords = fistula (Clic here for more details about this article) |
14/1789. Results of the surgical treatment of perimedullary arteriovenous fistulas with special reference to embolization.OBJECT: This retrospective study was performed to evaluate the results of surgical treatment and the use of preoperative embolization in managing patients with perimedullary arteriovenous fistulas (AVFs). methods: The authors studied 20 consecutive patients with perimedullary AVFs who underwent surgical treatment. Arteriovenous shunts were at the level of the cervical spine in five patients, the thoracic spine in 12, and the conus medullaris in three patients. Of the 20 AVFs, three were fed by the anterior spinal artery only, three by the posterior spinal artery, and 14 by both the anterior and posterior spinal arteries. Nine patients had varices that compressed the spinal cord. Eleven patients underwent surgery, and nine patients underwent surgery combined with adjuvant preoperative embolization. Preoperative embolization remarkably reduced blood flow through the AVFs and facilitated subsequent surgical procedures. Postoperative angiography revealed complete disappearance of the AVFs in 16 patients. However, small fistulas persisted in the other four patients, whose large lesions were fed by the anterior spinal artery. Postoperatively, neurological status was improved in 11 patients, unchanged in eight, and worse in one patient. CONCLUSIONS: Effective interruption of a spinal arteriovenous shunt was achieved by surgery in all cases, even when the anterior spinal artery was involved. For large and high-flow AVFs, embolization proved to be a useful adjunct to surgery.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
15/1789. Spinal dural arteriovenous fistula with an associated feeding artery aneurysm: case report.OBJECTIVE AND IMPORTANCE: A case of a spinal dural arteriovenous fistula (DAVF) with two associated feeding artery aneurysms is reported. Intradural spinal arteriovenous malformations have been associated with aneurysms that present with subarachnoid hemorrhage and with venous varices that produce mass effect, but spinal DAVFs have not previously been described in association with feeding artery aneurysms. CLINICAL PRESENTATION: A 71-year-old man presented with progressive spastic paraparesis, constipation, and overflow incontinence. magnetic resonance imaging demonstrated a spinal vascular lesion and venous ischemia in the lower spinal cord. Diagnostic spinal angiography revealed a DAVF originating from the left T11 radicular artery and having the unusual feature of two proximal feeding artery aneurysms. INTERVENTION: The patient deteriorated neurologically after undergoing angiography, prompting emergent surgery. The DAVF was resected through a T11 transpedicular approach. One aneurysm was dolichoectatic and therefore unclippable, requiring proximal occlusion of the parent artery after establishing tolerance of test occlusion using somatosensory evoked potentials; the second aneurysm was adjacent to the fistula and was resected with the DAVF. CONCLUSION: Feeding artery aneurysms in association with spinal DAVFs have not been previously reported. They present additional risk to patients and, with simple modifications of the standard operative approaches, can easily be treated as part of the surgery for the DAVF.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
16/1789. Resection of a large arteriovenous fistula of the brain using low-flow deep hypothermic cardiopulmonary bypass: technical case report.OBJECTIVE AND IMPORTANCE: We present the second report in the literature on the use of low-flow hypothermic cardiopulmonary bypass to aide in the surgical resection of a large intraparenchymal arteriovenous fistula. CLINICAL PRESENTATION: The patient was a 46-year-old man who was found to have a left sylvian arteriovenous fistula with a giant varix during a workup for chronic left frontal headaches and was referred to our center for management. A cardiac workup revealed a cardiac output of 9 L per minute. INTERVENTION: Endovascular embolization of the lesion was initially attempted without success because of the high flow within the lesion and the large diameter of the feeding arteries. We then planned combined and staged endovascular and surgical approaches to gradually eliminate the fistula. Endovascular embolization, both transarterial and transvenous, could not be performed because of the high flow in the fistula. Despite the stepwise reduction of flow during the course of several weeks via surgical exposures and arterial ligations, the fistula remained difficult to remove because of its size and the turgor of the varix. Once hypothermic low-flow circulatory bypass was used, however, decompression of the sac allowed access to the afferent vasculature. CONCLUSION: The use of low-flow hypothermic circulatory bypass can facilitate the surgical extirpation of certain large intraparenchymal arteriovenous fistulas.- - - - - - - - - - ranking = 2keywords = fistula (Clic here for more details about this article) |
17/1789. Chest wall arteriovenous fistula: an unusual complication after chest tube placement.Posttraumatic arteriovenous fistulas can form between vessels of the thorax that have sustained loss of integrity to the vessel wall. Although most are caused by injuries as a consequence of missile penetration or stab wounds, iatrogenic damage is a potential cause. Herein we present a case of a systemic arteriovenous fistula involving an intercostal artery and subcutaneous vein after chest tube placement.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
18/1789. Therapeutic embolization for unusual latrogenic complications related to coronary revascularization.Percutaneous therapeutic embolization may be an effective strategy to manage distal coronary perforations or inadvertent iatrogenic coronary arteriovenous fistula complicating revascularization procedures. We present two cases in which embolization techniques were used to manage these patients and avoid the need for surgical intervention.- - - - - - - - - - ranking = 0.2keywords = fistula (Clic here for more details about this article) |
19/1789. exercise-induced ventricular tachycardia associated with coronary arteriovenous fistula and correction by transcatheter coil embolization.exercise-induced ventricular tachycardia is a well-described arrhythmia most commonly associated with atherosclerotic coronary artery disease. The case reported here presents its association with a coronary arteriovenous fistula, which has not been previously reported in the literature.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
20/1789. Percutaneous transfemoral embolization of an indirect carotid-cavernous fistula with cortical venous access to the cavernous sinus. Case report.The authors present the case of a 61-year-old man with an indirect carotid-cavernous fistula (CCF). Many now advocate a primary transvenous approach to deal with such lesions, with packing and thrombosis of the cavernous sinus leading to fistula obliteration. Transvenous access to the cavernous sinus via the inferior petrosal sinus is the usual route of access; both surgical and transfemoral superior ophthalmic vein approaches are also well described. In the case presented, the anatomy of the CCF was unfavorable for these approaches and its dominant venous egress was via a single enlarged arterialized cortical vein. The cavernous sinus was accessed with a transfemoral retrograde approach to the cortical draining vein. Successful CCF embolization was documented radiographically and clinically. To the authors' knowledge, this procedure has not been previously described in the English literature.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
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