1/33. A large coronary artery saphenous vein bypass graft aneurysm with a fistula: case report and review of the literature.We describe a patient who developed a large aneurysm of saphenous vein graft to the right coronary artery with a fistulous communication to the right atrium. The presence of a fistulous communication of a saphenous vein graft aneurysm after coronary bypass surgery to one of the heart chambers is extremely rare. The diagnosis was made by coronary angiography and confirmed by CT and MRI. At surgery the aneurysm was ligated and excised. The fistula to the right atrium was closed. Repeat coronary artery bypass surgery with aortic valve replacement was performed at the same time without complications. Cathet. Cardiovasc. Intervent. 48:214-216, 1999.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
2/33. Congestive heart failure due to adjuvant arteriovenous fistula in a femoroperoneal bypass.The authors describe a patient who developed congestive heart failure one month after femoroperoneal bypass and adjuvant common ostium arteriovenous fistula procedure. The occlusion of the concomitant vein proximally to the arteriovenous fistula promptly resolved such a serious complication which, to our knowledge, has never been described previously.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
3/33. Results of saphenous vein graft stent implantation: single center results from use of oversized balloon catheters.The results and complications of a single-center experience of stent implantation in old saphenous vein grafts (SVGs) need to be defined. The authors studied their initial consecutive 92 patients (125 stents, 1.4 stents/per patient) with a mean age of 67 /-9 years. The patients' mean saphenous vein graft (SVG) age was 10 /-4 years, and the mean left ventricular ejection fraction was 46% /-15. Patient population included unstable angina (65%), stable angina (10%), myocardial infarction (21%), and silent ischemia (4%). The authors implanted 122 Palmaz-Schatz/biliary and three Gianturco-Roubin stents. They aimed at a balloon-artery ratio of 1.1/1.0. Procedural success, defined as stent deployment with <50% stenosis without death/Q-wave myocardial infarction/coronary artery bypass grafting (MI/CABG) was 95%. The mean luminal diameter (MLD) increased from 0.6 /-0.5 to 3.3 /-0.8 mm (p<0.001) and mean SVG stenosis diameter was decreased from 80% /-14 to -10% /-11 (p<0.001). Angiographic SVG lesions exhibited thrombus (17%), ulceration (38%), and plaque rupture (28%). Sixty-two patients were treated with warfarin and aspirin and 30 with ticlid and aspirin. Complications included death in three patients (3.3%) who sustained subacute stent thrombosis, and two of three had Q-wave MI. Distal embolization occurred in seven patients (8%); six of seven sustained a non Q-wave acute myocardial infarction (AMI); and one of seven a Q-wave MI. Eight (9%) patients had major groin hematoma, two had pseudoaneurysm (2.2%), one had arteriovenous (A-V) fistula (1.1%), two had vascular surgery (2.2%), nine had blood transfusion (9.8%), and three had stent migration (3.3%). Single-center experience with stents in SVGs indicates a highly successful procedural and angiographic immediate result. However, it was complicated by significant risk of non Q-wave MI due to distal coronary embolization which may affect prognosis.- - - - - - - - - - ranking = 0.2keywords = fistula (Clic here for more details about this article) |
4/33. Iatrogenic arteriovenous fistula in a renal allograft: the result of a TAD guidewire injury.A case is presented of an iatrogenic arteriovenous fistula developing in a renal allograft following guidewire manipulation during transplant renal artery angioplasty. Hyperdynamic flow through the fistula was causing a shunt of blood away from the renal cortex as demonstrated on sonography and scintigraphy. Selective embolization was performed, correcting the maldistribution of flow to the peripheral renal cortex. The diagnosis and difficulty in management of asymptomatic renal arteriovenous fistulae is also discussed.- - - - - - - - - - ranking = 1.4keywords = fistula (Clic here for more details about this article) |
5/33. Contralateral internal jugular vein interposition for salvage of a functioning arteriovenous fistula.Outflow obstruction in patients with hemodialysis access can cause venous hypertension and jeopardize the patency of the access site. Numerous surgical procedures have been described to decompress an occluded subclavian vein. In this report, we describe the use of the contralateral internal jugular vein as a bypass conduit to decompress an occluded brachiocephalic vein in a patient whose dialysis was dependent on this vein access.- - - - - - - - - - ranking = 0.8keywords = fistula (Clic here for more details about this article) |
6/33. Coronary steal from a left internal mammary artery coronary bypass graft by a left upper extremity arteriovenous hemodialysis fistula.In patients with end-stage renal disease undergoing hemodialysis, the upper extremity arteriovenous (AV) fistula is the dialysis access recommended by the DOQI guidelines for patients with appropriate vasculature. upper extremity AV fistulae have long periods of usefulness, high flow rates, and low associated complication rates. Placement of AV access may result in increased cardiac output and increased cardiac oxygen demand in these patients. In general, cardiovascular complications from AV access have been limited. We report a novel cardiovascular complication of AV access in an end-stage renal disease patient with a coronary artery bypass graft employing the left internal mammary artery who experienced angina while undergoing hemodialysis. The angina was mediated at least in part by cardiac catheterization laboratory-documented steal of blood flow from the internal mammary artery graft. This phenomenon suggests the need to consider the impact of upper extremity access placement on blood flow to the left internal mammary artery in patients who previously have undergone placement of a coronary artery bypass graft.- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
7/33. Cutting balloon angioplasty for undilatable venous stenoses causing dialysis graft failure.dialysis fistulas and bridge grafts frequently develop outflow stenoses in the venous limb, leading to graft failure. The venous stenoses are fibrotic and require percutaneous transluminal angioplasty with high-pressure balloons. We have encountered venous stenoses in 3 out of 219 hemodialysis patients with graft failure that were undilatable with 6-8 mm high-pressure balloons inflated to more than 24 atm. In each of these cases, treatment with a 4 mm cutting balloon successfully facilitated subsequent balloon dilation at lower pressures.- - - - - - - - - - ranking = 0.2keywords = fistula (Clic here for more details about this article) |
8/33. Apparent obstruction of the superior vena cava and a continuous murmur: signs of a fistula between a vein graft aneurysm and the right atrium.A previously undescribed complication of a saphenous vein aortocoronary bypass graft, namely formation of a fistula between a vein graft aneurysm and the right atrium is reported. A patient presented with a continuous murmur and a combination of signs suggesting superior vena cava obstruction. This pathology was shown by both echocardiography and angiography. Surgical treatment was attempted.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
9/33. An interesting case of early arteriovenous fistula failure: how I would code it.Treatment of early fistula failure can present a challenge as it relates to the evaluation and treatments required for successful management. It can also present a challenge related to accurate and correct coding of the procedures performed. A clinical case is presented in order to discuss the coding of a case with early fistula failure. The procedure is analyzed in detail in order to determine the appropriate codes to apply to the case. The coding is done in accordance with the principles adopted by the American Society of Diagnostic and Interventional nephrology (ASDIN).- - - - - - - - - - ranking = 1.2keywords = fistula (Clic here for more details about this article) |
10/33. Ureteroarterial fistula with ruptured anastomotic pseudoaneurysm: successful management with vascular exclusion, extra-anatomic bypass and nephrectomy--a case report.Ureteroarterial fistula is a rare but life-threatening condition most often arising as a consequence of combined vascular and urologic pathology. Only about 70 cases are reported in the English literature. Principles of repair include complete vascular isolation, extra-anatomic bypass, and urinary stream diversion away from major vascular conduits. The case presented herein is only the second reported instance of fistulization to an anastomotic pseudoaneurysm of an iliopopliteal bypass.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
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