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Int. braz. j. urol ; 47(1): 149-158, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1134310


ABSTRACT Purpose: Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function. Materials and Methods: Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated. Results: Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p <0.05). In the multivariate analysis, higher N component scores were associated with the occurrence of RAPs/AVFs (Odds ratio: 1.96, p=0.039). In the SAE group, the mean 3-day postembolization eGFR was significantly lower than the mean 3-day postoperative eGFR (p <0.01). This difference in the eGFRs was still present 1 year later. Conclusions: Renal tumors located near the renal sinus and collecting system were associated with a higher risk for RAPs/AVFs after PN. Although SAE was an effective method for controlling symptomatic RAPs/AVFs after PN, a procedure-related impairment of renal function after SAE could occur and still be present at the end of the first postoperative year.

Humans , Arteriovenous Fistula/etiology , Aneurysm, False/etiology , Kidney Neoplasms/surgery , Retrospective Studies , Treatment Outcome , Glomerular Filtration Rate , Nephrectomy/adverse effects
Rev. Hosp. Ital. B. Aires (2004) ; 39(3): 94-97, sept. 2019. ilus.
Article in Spanish | LILACS | ID: biblio-1048277


Las fístulas arteriovenosas durales medulares son malformaciones vasculares adquiridas que constituyen una causa muy infrecuente de mielopatía progresiva (5-10 casos por millón de habitantes por año). La resonancia magnética es el estudio por imágenes de elección para su diagnóstico. A continuación presentamos el caso de una paciente femenina de 89 años, que consultó a la guardia de nuestra institución por un cuadro de paraparesia moderada asociada a parestesias e incontinencia urinaria posterior a esfuerzo físico. Se le diagnosticó una fístula arteriovenosa dural medular como causante de su cuadro. (AU)

Spinal dural arteriovenous fistulas (SDAVF) are acquired spinal vascular malformations and a rare cause of progressive myelopathy (5-10 new cases per year and per 1 million inhabitants). Magnetic resonance imaging is the diagnosis modality of choice. We present a case of a 89-year-old female patient who consulted the emergency department of our institution because of paraparesis and lower extremities paresthesias associated with urinary incontinence post physical effort. With the final diagnosis of spinal dural arteriovenous fistula, as a cause of the clinical symptoms. (AU)

Humans , Male , Female , Middle Aged , Aged, 80 and over , Arteriovenous Fistula/diagnostic imaging , Dura Mater/abnormalities , Paresthesia , Atrial Fibrillation/complications , Spinal Cord Diseases/diagnostic imaging , Tobacco Use Disorder/complications , Urinary Incontinence , Arteriovenous Fistula/etiology , Arteriovenous Fistula/epidemiology , Low Back Pain/complications , Aortic Aneurysm, Abdominal/complications , Paraparesis , Fecal Incontinence , Hypertension/complications , Hypesthesia , Erectile Dysfunction , Anticoagulants/therapeutic use
Rev. bras. cir. cardiovasc ; 33(6): 631-633, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-977485


Abstract Arteriovenous fistula due to coronary angiography intervention is rarely seen. Arteriovenous fistulas may be asymptomatic according to the size of the shunt, as well as to the heart failure. In this case report, we aimed to share gradual transition from endovascular methods to surgery and why surgical treatment is required for a patient who developed arteriovenous fistula after coronary angiography.

Humans , Male , Middle Aged , Arteriovenous Fistula/etiology , Coronary Angiography/adverse effects , Femoral Artery/diagnostic imaging , Arteriovenous Fistula/surgery , Arteriovenous Fistula/diagnostic imaging
Rev. chil. reumatol ; 32(2): 40-48, 2016. ilus
Article in Spanish | LILACS | ID: biblio-869812


El Síndrome de Ehlers-Danlos Vascular es una de las Alteraciones Hereditarias del Tejido Conectivo. Es poco frecuente, pero es de alta morbilidad y mortalidad. Se debe a una mutación del gen COL3A1, que da debilidad del tejido colágeno, por lo que se pueden producir complicaciones graves afectando a la piel, tubo digestivo, hígado, pulmón y sistema vascular. Se pueden producir rupturas intestinales, neumotórax espontáneo, dilatación o ruptura aortica y anuerismas, lo que puede llevar a la muerte súbita del paciente.

The Vascular Ehlers-Danlos is one of Hereditary Diseases of Connective Tissue. Has low prevalence, but high morbidity and mortality. It is due to a COL3A1 gene mutation, producing tissue fragility, which can produce serious complications in the skin, digestive tract, liver, lungs and in the vascular system. It is frequently associated to intestinal ruptures, spontaneous pneumothorax, dilation or rupture of the aorta anuerism, which can lead to sudden death.

Humans , Ehlers-Danlos Syndrome/complications , Ehlers-Danlos Syndrome/diagnosis , Death, Sudden , Diagnosis, Differential , Arteriovenous Fistula/etiology , Joint Instability/complications , Ehlers-Danlos Syndrome/therapy
Rev. bras. neurol ; 51(1): 6-11, jan.-mar. 2015. ilus
Article in English | LILACS | ID: lil-749259


As fístulas arteriovenosas (FAVs) e os pseudoaneurismas traumáticos extracranianos são malformações incomuns e, em sua maioria, estão associadas a traumatismo craniano fechado com lesão contusa de forte intensidade. O diagnóstico em geral é clínico, porém o exame de escolha para o diagnóstico definitivo é a angiografia. Nos casos em que a lesão é pequena, é possível abordá-la com embolização via endovascular com sucesso. A excisão cirúrgica, no entanto, ainda é o método de escolha para o tratamento. É relatado um caso de um paciente do sexo masculino, com 9 anos de idade, diagnosticado com FAV, acometendo o ramo frontal da artéria temporal superficial, secundária a trauma craniano contundente ocorrido três anos antes do diagnóstico.

The arteriovenous fistulae (AVFs) and the extracranial traumatic pseudoaneurysms are uncommon malformations and in the majority of the cases are associated to closed head trauma with high intensity blunt lesion. The diagnosis is generally clinical, though the exam of choice for definitive diagnosis is an angiography. In minor lesion cases it's possible to successfully approach it with endovas-cular embolization. The surgical excision though, is the method of choice for the treatment. Here is reported a case of a 9-year-old male patient, diagnosed with AVF involving the frontal branch of the superficial temporal artery, secondary to blunt head trauma occurred three years before diagnosis.

Humans , Male , Child , Arteriovenous Fistula/surgery , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/etiology , Aneurysm, False/surgery , Angiography , Tomography, X-Ray Computed/statistics & numerical data , Head Injuries, Closed/complications
Int. braz. j. urol ; 40(4): 568-573, Jul-Aug/2014. graf
Article in English | LILACS | ID: lil-723971


Main findings We describe the use of a novel endoscopic approach in the management of unremitting gross hematuria following post-percutaneous nephrolithotomy (PCNL) in a 65-years-old male. This approach proved successful and cost-effective in managing haemorrhage post-PCNL when renal angiography failed to localize the source of bleeding. Case hypothesis The recommended treatment modality for renal calculi ≥ 2cm is PCNL. It is essential that clinicians are aware of the various complications that can arise from PCNL, including arteriovenous fistula, which is typically managed with renal angio-embolization. The development of a renal arteriopelvic fistula (APF) is an extremely rare complication, and accounts of haemorrhage from renal APF and its treatment have not been well-described in the literature. We successfully hypothesized that the ureteroscopic localization, fulguration, and closure with a fibrin sealant at the site of the arterial bleed results in optimal treatment for this clinical presentation. We report this case in detail. Promising Future Implications The successful and cost-effective endoscopic approach described here for treatment of post-PCNL renal APF and unremitting gross hematuria ought to be considered as an adjunct to renal angiography and embolization when the source of bleeding cannot be accurately identified using traditional imaging modalities. .

Aged , Humans , Male , Arteriovenous Fistula/surgery , Hematuria/surgery , Nephrostomy, Percutaneous/adverse effects , Postoperative Complications/surgery , Renal Artery/injuries , Ureteroscopy/methods , Arteriovenous Fistula/etiology , Hematuria/etiology , Kidney Pelvis/injuries , Kidney Pelvis/surgery , Postoperative Complications/etiology , Renal Artery/surgery , Treatment Outcome
Arq. bras. neurocir ; 33(2)jun. 2014. ilus
Article in Portuguese | LILACS | ID: lil-721669


Os autores descrevem o caso de um doente de 34 anos que, após agressão sofrida em 2008, detectou o surgimento de tumoração no mesmo local em que sofrera a agressão, onde surgiu uma fístula arteriovenosa cutânea pós-traumática, documentada por meio de angiografia digital. Tanto o doente quanto a equipe médica optaram por conduta não cirúrgica, e o doente segue assintomático no seguimento ambulatorial, sem modificação da fístula desde seu diagnóstico.

The authors describe a 34 years old men with cutaneous vascular disorder after a cranial injury suffered three months ago. Subsidiary investigation by angiography showed a cutaneous arteriovenous malformation. The men asymptomatic, have a non-surgical conduct and he is very well after three years.

Humans , Male , Adult , Cerebral Angiography , Embolization, Therapeutic , Arteriovenous Fistula/etiology , Craniocerebral Trauma/complications , Aneurysm
Article in English | WPRIM | ID: wpr-187065


We present a case of a patient with rapid deterioration of esophageal varices caused by portal hypertension accompanied by a large arterioportal shunt that developed after radiofrequency ablation of hepatocellular carcinoma. We used n-butyl cyanoacrylate (NBCA) as an embolic material to achieve pinpoint embolization of the shunt, because the microcatheter tip was 2 cm away from the shunt site. Under hepatic arterial flow control using a balloon catheter, the arterioportal shunt was successfully embolized with NBCA, which caused an improvement in the esophageal varices.

Aged , Arteriovenous Fistula/etiology , Carcinoma, Hepatocellular/surgery , Catheter Ablation/adverse effects , Embolization, Therapeutic/methods , Enbucrilate/therapeutic use , Esophageal and Gastric Varices/etiology , Hepatic Artery/abnormalities , Humans , Liver Neoplasms/surgery , Male , Portal Vein/abnormalities
Article in English | WPRIM | ID: wpr-18372


Hepatopulmonary syndrome (HPS) is a serious complication of end-stage liver disease, which is characterized by hypoxia, intrapulmonary vascular dilatation, and liver cirrhosis. Liver transplantation (LT) is the only curative treatment modality for patients with HPS. However, morbidity and mortality after LT, especially in cases of severe HPS, remain high. This case report describes a patient with typical findings of an extracardiac pulmonary arteriovenous shunt on contrast-enhanced transesophageal echocardiography (TEE), and clubbing fingers, who had complete correction of HPS by deceased donor LT. The patient was a 16-year-old female who was born with biliary atresia and underwent porto-enterostomy on the 55th day after birth. She had been suffered from progressive liver failure with dyspnea, clubbing fingers, and cyanosis. Preoperative arterial blood gas analysis revealed severe hypoxia (arterial O2 tension of 54.5 mmHg and O2 saturation of 84.2%). Contrast-enhanced TEE revealed an extracardiac right-to-left shunt, which suggested an intrapulmonary arteriovenous shunt. The patient recovered successfully after LT, not only with respect to physical parameters but also for pychosocial activity, including school performance, during the 30-month follow-up period.

Adolescent , Hypoxia , Arteriovenous Fistula/etiology , Biliary Atresia/diagnosis , Cyanosis/complications , Dyspnea/complications , Echocardiography, Transesophageal , End Stage Liver Disease/complications , Female , Hepatic Artery/abnormalities , Hepatopulmonary Syndrome/diagnosis , Humans , Liver Transplantation , Osteoarthropathy, Secondary Hypertrophic/complications
Rev. chil. neurocir ; 38(1): 43-46, jun. 2012. ilus
Article in Spanish | LILACS | ID: lil-716513


La arteria temporal superficial es particularmente vulnerable al trauma debido a su largo trayecto en el cuero cabelludo y relativa vulnerabilidad sin embargo las fístulas arteriovenosas del cuero cabelludo son una patología infrecuente. Presentamos un caso de una paciente femenina quien 2 años posterior a un trauma lacerante del cuero cabelludo presenta una fístula arteriovenosa traumática de la arteria temporal superficial, tratada de manera exitosa mediante la extirpación quirúrgica, se realiza una revisión de la literatura con respecto a la etiología, manifestaciones clínicas, patogenia, diagnóstico y su tratamiento.

The superficial temporal artery is particularly vulnerable to trauma because of its long journey in the scalp and relative vulnerability butth escalp arteriovenous fistulas arean uncommon finding. We report a case of a female patient who 2 years after a shearing trauma of the scalp has a superficial temporal artery (STA) traumatic arteriovenous fistula (TAVF), treated successfully by surgical removal. We review the literature regarding the etiology, clinical manifestations, pathogenesis, diagnosis and treatment.

Humans , Female , Young Adult , Temporal Arteries/injuries , Scalp/injuries , Arteriovenous Fistula/surgery , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/epidemiology , Arteriovenous Fistula/etiology , Diagnostic Imaging
Rev. chil. cir ; 63(6): 623-626, dic. 2011. ilus
Article in Spanish | LILACS | ID: lil-608757


Aortocaval fistula (ACF) is an infrequent complication of abdominal aortic aneurysm (AAA). Diagnosis is suspected by the presence of a continuous abdominal bruit and pulsatile abdominal mass, with variable signs of venous congestion and acute heart failure. Multislice computed tomography (MSCT) is useful in establishing the diagnosis, showing early enhancement of inferior vena cava and, in some cases, identifying the arteriovenous comunication. Surgical treatment is usually complex, with high morbidity and mortality rates. Endovascular treatment seems to be a promising alternative for the management of these patients. We report a case of ACF treated with open surgery and a literature review of this rare condition.

La fístula aortocava (FAC) es una complicación infrecuente del aneurisma aórtico abdominal (AAA). El diagnóstico se sospecha por la detección de un soplo continuo en el hemiabdomen inferior, asociado a masa abdominal pulsátil y signos variables de congestión venosa e insuficiencia cardíaca. La tomografía computada multicorte (TCM) permite confirmar el diagnóstico, evidenciando contraste de la vena cava inferior en fase arterial e identificando la zona anatómica de la comunicación arteriovenosa, en algunos casos. La reparación quirúrgica suele ser compleja, reportándose una alta morbi-mortalidad asociada. El uso de técnicas endovasculares pareciera mejorar el pronóstico de esta entidad. Reportamos un caso de FAC tratado mediante cirugía abierta. Se incluye una revisión de la literatura respecto a esta rara condición.

Humans , Male , Aged , Aortic Aneurysm, Abdominal/complications , Arteriovenous Fistula/surgery , Arteriovenous Fistula/etiology , Vena Cava, Inferior/surgery , Aortic Aneurysm, Abdominal , Fatal Outcome , Arteriovenous Fistula , Tomography, X-Ray Computed/methods , Vena Cava, Inferior/abnormalities , Vena Cava, Inferior
Rev. argent. ultrason ; 7(2): 140-141, jun. 2008. ilus
Article in Spanish | LILACS | ID: lil-506157


Caso clínico luego de realizarse una ecografía en la semana 31 de gestación, en el que se detectó una dilatación aneurismática de la vena de Galeno.

Humans , Female , Pregnancy , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/etiology , Arteriovenous Fistula/therapy , Arteriovenous Fistula , Ultrasonography, Prenatal , Cerebral Veins/injuries , Cerebral Veins
Arq. bras. cardiol ; 90(4): e21-e23, abr. 2008. ilus
Article in English, Portuguese | LILACS | ID: lil-482962


Descrevemos caso de paciente do sexo masculino, 49 anos, que sofreu ferimento por arma de fogo no tórax, transfixando o mediastino médio. Apresentava-se estável hemodinamicamente, contudo taquicárdico e taquipnéico. Ele foi submetido à propedêutica armada com radiograma de tórax, ecocardiografia transtorácica, tomografia computadorizada de tórax e arteriografia do arco aórtico. Evidenciou-se fístula traumática do tronco braquiocefálico com a veia braquiocefálica. Realizou-se correção cirúrgica com a utilização de circulação extracorpórea e hipotermia profunda com parada circulatória total. O paciente evolui bem com alta no quinto pós-operatório.

We describe the case of a 49-year old male patient who suffered a gunshot wound in the chest which transfixed the medial mediastinum. He was hemodynamically stable, but had tachycardia and tachypnea. He was submitted to integrated work-up with chest radiogram, transthoracic echocardiography, computerized chest tomography, and arteriography of the aortic arch. A traumatic fistula was evidenced between the brachiocephalic trunk and the brachiocephalic vein. Surgical repair was performed using extracorporeal circulation and deep hypothermia with total circulatory arrest. The patient progressed well and was discharged on the fifth day postoperatively.

Humans , Male , Middle Aged , Arteriovenous Fistula , Brachiocephalic Trunk/injuries , Brachiocephalic Veins/injuries , Wounds, Gunshot/complications , Arteriovenous Fistula/etiology , Brachiocephalic Trunk , Brachiocephalic Veins
Article in English | WPRIM | ID: wpr-65656


An endovascular intervention is a feasible alternative to the technically challenging conventional surgery for the treatment of traumatic vertebral arterial lesions. This report describes a rare case involving a 22-year-old patient with a traumatic vertebral arterial pseudoaneurysm and multiple arteriovenous fistulas which were successfully sealed using the endovascular stent-graft technique.

Adult , Aneurysm, False/etiology , Angiography , Arteriovenous Fistula/etiology , Humans , Jugular Veins/diagnostic imaging , Male , Stents , Vertebral Artery/injuries
Article in English | WPRIM | ID: wpr-182496


Arthroscopic meniscectomy of the knee is generally a safe and effective procedure with a low rate of vascular complications. We report here on a unique case of a 55-year-old man with a lateral inferior genicular artery pseudoaneurysm and a concomitant arteriovenous fistula that developed after arthroscopic meniscectomy; this was successfully treated with selective angiographic embolization. This case illustrates the effectiveness of an endovascular approach as a minimally invasive treatment for this uncommon complication that occurs after an arthroscopic procedure.

Aneurysm, False/etiology , Angiography , Arteriovenous Fistula/etiology , Arthroscopy/adverse effects , Embolization, Therapeutic/methods , Humans , Knee Joint/diagnostic imaging , Leg/blood supply , Male , Middle Aged
Indian Heart J ; 2005 Nov-Dec; 57(6): 725-7
Article in English | IMSEAR | ID: sea-4049


The left internal mammary artery is frequently employed as a conduit in coronary bypass surgery. We report a 42-year-old male post-coronary artery bypass grafting patient with, angina on exertion who was found to have multiple atrioventricular fistulae arising from left internal mammary artery to pulmonary vasculature leading to coronary steal and positive stress thallium in left anterior descending territory. These fistulae were selectively embolized with polymer particles leading to improved flow in distal left anterior descending artery. Postintervention, the patient has been asymptomatic for more than 8 months.

Adult , Angina Pectoris/diagnosis , Arteriovenous Fistula/etiology , Balloon Occlusion/methods , Coronary Angiography , Coronary Artery Bypass/methods , Coronary Circulation/physiology , Embolization, Therapeutic/methods , Follow-Up Studies , Humans , Internal Mammary-Coronary Artery Anastomosis/adverse effects , Male , Myocardial Ischemia/diagnosis , Polymers/therapeutic use , Risk Assessment , Treatment Outcome