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1.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);63(7): 564-565, July 2017. graf
Article in English | LILACS | ID: biblio-896370

ABSTRACT

Summary Subacute necrotizing myelopathy (SNM) or Foix-Alajouanine syndrome is a rare disease characterized by progressive neurological dysfunction caused by a spinal dural arteriovenous fistula (AVF). Radiological diagnosis is usually suspected when there is intramedullary nonspecific enhancement and perimedullary flow voids. Ring-enhancement is rarely reported in the scope of AVF, which poses a diagnostic challenge and raises the suspicion of a spinal cord tumor. In such situations, biopsy can be required and delay proper diagnosis. We report the case of a patient with SNM, who underwent biopsy on the assumption of it being a spinal cord tumor.


Resumo Mielopatia necrotizante subaguda (MNS) ou síndrome de Foix-Alajouanine é uma doença rara que se caracteriza por disfunção neurológica progressiva causada por uma fístula arteriovenosa espinal dural. O diagnóstico radiológico é comumente suspeitado quando aparece captação não específica de contraste e de artefatos de fluxo (flow voids) perimedulares. Raramente, a captação de contraste exibe o aspecto em anel, constituindo um grande desafio diagnóstico. Nesses casos, o principal diagnóstico diferencial é um tumor intramedular, e os pacientes são encaminhados para biópsia da lesão, atrasando o diagnóstico definitivo. Relatamos o caso de uma paciente com MNS, a qual foi submetida à biópsia da lesão em virtude de suspeita de tumor intramedular.


Subject(s)
Humans , Female , Aged , Spinal Cord Diseases/diagnostic imaging , Spinal Cord Neoplasms/diagnostic imaging , Arteriovenous Fistula/diagnostic imaging , Spinal Cord/pathology , Spinal Cord/diagnostic imaging , Spinal Cord Diseases/surgery , Spinal Cord Diseases/pathology , Spinal Cord Neoplasms/pathology , Syndrome , Biopsy , Angiography , Arteriovenous Fistula/pathology , Diagnosis, Differential
2.
Yonsei med. j ; Yonsei med. j;: 397-402, 2015.
Article in English | WPRIM | ID: wpr-141642

ABSTRACT

PURPOSE: Magnetic resonance imaging (MRI) has been used to screen and follow-up spinal dural arteriovenous fistulae (SDAVF). The purpose of this study was to evaluate the association between MRI findings and neurologic function in SDAVF. This study also investigated clinical features and treatment results of SDAVF. MATERIALS AND METHODS: A total of 15 consecutive patients who underwent embolization or surgery for SDAVF were included. We treated seven (60%) patients with embolization and six (40%) with surgery. We analysed clinical features, MRI findings, treatment results, and neurologic function. Neurologic function was measured by the Aminoff-Logue disability scale (ALS). RESULTS: Patients with longer levels of intramedullary high signal intensity in preoperative T2-weighted images (T2WI) exhibited worse pre- and postoperative ALS scores (r=0.557, p=0.031; r=0.530, p=0.042, Pearson correlation). Preoperative ALS score was significantly correlated with postoperative ALS score (r=0.908, p=0.000, Pearson correlation). The number of levels showing intramedullary high signal intensity in T2WI decreased significantly postoperatively (5.2+/-3.1 vs. 1.0+/-1.4, p=0.001, Wilcoxon ranked test). CONCLUSION: The number of involved levels of high signal intensity in preoperative T2WI is useful for predicting pre- and postoperative neurologic function in SDAVF.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angiography , Arteriovenous Fistula/pathology , Central Nervous System Vascular Malformations/pathology , Embolization, Therapeutic/methods , Magnetic Resonance Imaging , Postoperative Period , Predictive Value of Tests , Prognosis , Retrospective Studies , Severity of Illness Index , Spinal Cord/abnormalities , Treatment Outcome
3.
Yonsei med. j ; Yonsei med. j;: 397-402, 2015.
Article in English | WPRIM | ID: wpr-141643

ABSTRACT

PURPOSE: Magnetic resonance imaging (MRI) has been used to screen and follow-up spinal dural arteriovenous fistulae (SDAVF). The purpose of this study was to evaluate the association between MRI findings and neurologic function in SDAVF. This study also investigated clinical features and treatment results of SDAVF. MATERIALS AND METHODS: A total of 15 consecutive patients who underwent embolization or surgery for SDAVF were included. We treated seven (60%) patients with embolization and six (40%) with surgery. We analysed clinical features, MRI findings, treatment results, and neurologic function. Neurologic function was measured by the Aminoff-Logue disability scale (ALS). RESULTS: Patients with longer levels of intramedullary high signal intensity in preoperative T2-weighted images (T2WI) exhibited worse pre- and postoperative ALS scores (r=0.557, p=0.031; r=0.530, p=0.042, Pearson correlation). Preoperative ALS score was significantly correlated with postoperative ALS score (r=0.908, p=0.000, Pearson correlation). The number of levels showing intramedullary high signal intensity in T2WI decreased significantly postoperatively (5.2+/-3.1 vs. 1.0+/-1.4, p=0.001, Wilcoxon ranked test). CONCLUSION: The number of involved levels of high signal intensity in preoperative T2WI is useful for predicting pre- and postoperative neurologic function in SDAVF.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angiography , Arteriovenous Fistula/pathology , Central Nervous System Vascular Malformations/pathology , Embolization, Therapeutic/methods , Magnetic Resonance Imaging , Postoperative Period , Predictive Value of Tests , Prognosis , Retrospective Studies , Severity of Illness Index , Spinal Cord/abnormalities , Treatment Outcome
4.
Gac. méd. Caracas ; 120(3): 218-224, jul.-sept. 2012. ilus
Article in Spanish | LILACS | ID: lil-706243

ABSTRACT

Las sinquinesis son movimientos simultáneos o coordinados en secuencia de mivimientos de músculos suplidos por diferentes nervios o por ramas independientes del mismo nervio que ocurren luego de la recuperación de una lesión axonal periferica; son debidos a la dirección errónea ("misdirection") que toman algunos axones hacia otros músculos que no constituyen su objetivo o blanco; así, cuando el paciente intenta mover algunos músculos, ocurren contracciones involuntarias en otros, no esperadas anatómicamente. Es una suerte de recableado mal realizado y confuso. En las dos pacientes que constituyen nuestro informe, ocurrieron alteraciones óculomotoras excepcionales. En la primera de 60 años portadora de un aneurisma gigante del senocavernoso izquierdo, la sinquinesis nerviosa aberrante ocurrió entre los nervios craneales tercero y sexto. En la segunda de 22 años a quien se resecó un osteocondroma gigante de la fosa media derecha, desarrolló una parálisis total del tercer nerviocraneal con sinquinesis trigémino-oculomotora entre el músculo pterigoideo derecho y el elevador del párpado superior; así como también entre el tercero (recto inferior) y sexto nervios (recto externo) ipsolateral. Se revisa la literatura al respecto.


Synkinesis are simultaneous or coordinated sequential movements of muscles that are supplied by different nerves or have independent nerve branches. They occur after the recovery a peripheral axonal injury. They are due to axons taking a wrong direction ("misdirection") towards muscles that do not constitute their objetives or targets. Thus, when the patient attempts to move a muscle, other muscles show anatomically unexpected involuntary contractions. It is a sort of confusing rewiring. Our report is based on the exceptional oculomotor alterations that occurred in two patients. In the first patient, a 60 years-old female carrying a giant aneurysm of the left cavernous sinus, the aberrant nerve synkinesis ocurred between the third and sixth cranial nerves. In the second patient, a 22 year-old female to whom was resected a giant osteochondroma of the right middle fossa, developed a total paralysis of the third cranial nerve with trigeminal oculomotor synkinesis between the right pterygoid muscle and the elevator of the upper eyelid; as well as between the inferior rectus and ipsilateral external rectus. We review the literature on the subject.


Subject(s)
Humans , Female , Young Adult , Aged , Axons/physiology , Blepharoptosis/pathology , Nervous System Diseases/pathology , Facial Muscles/physiopathology , Osteochondroma/pathology , Oculomotor Nerve Injuries/complications , Oculomotor Nerve Injuries/physiopathology , Arteriovenous Fistula/pathology , Ophthalmology , Bell Palsy/pathology
5.
J. vasc. bras ; 8(3): 219-224, set. 2009. graf
Article in English, Portuguese | LILACS | ID: lil-535588

ABSTRACT

CONTEXTO: A síndrome de Klippel-Trénaunay-Weber é uma doença rara sobre a qual encontramos poucos artigos na literatura (geralmente relatos de casos esporádicos relacionados a complicações). OBJETIVO: Avaliar o perfil epidemiológico dos portadores da referida síndrome. MÉTODOS: Foram copilados dados dos prontuários de 58 pacientes acompanhados no ambulatório de doenças linfáticas e angiodisplasias da disciplina de Cirurgia Vascular da Faculdade de Ciências Médicas da Santa Casa de São Paulo. RESULTADOS: A distribuição foi igual entre homens e mulheres (30 homens e 28 mulheres). A idade média dos pacientes em tratamento foi de 12,8 anos. Na maioria dos casos, a doença foi diagnosticada na infância, sendo a mancha em vinho do porto o primeiro sinal notado pela família, no nascimento ou primeiro ano de vida. O sintoma mais referido foi a dor, normalmente relacionada aos sintomas de estase venosa, sendo o sintoma considerado debilitante. Pela classificação CEAP, encontramos as crianças nas classes C0 e C1 e a maioria dos adultos nas classes avançadas. Foi diagnosticada a presença de fístulas arteriovenosas em 8,5 por cento dos casos. Apenas 6,8 por cento referiram história familiar. CONCLUSÃO: A síndrome de Klippel-Trénaunay e a síndrome de Parkes Weber são apresentações diferentes de uma única enfermidade e podem ser estudadas conjuntamente como síndrome de Klippel-Trénaunay-Weber. O melhor momento para reconhecer os portadores e poder amenizar a progressão de insuficiência venosa, hipertrofia óssea e tecidos moles é a infância. O tratamento compressivo deve ser indicado a todos os portadores com o intuito de diminuir a evolução da doença venosa periférica.


BACKGROUND: Klippel-Trenaunay-Weber syndrome is a rare disorder about which there are few articles available (most of them are sporadic case reports related to complications). OBJECTIVE: To assess the epidemiological profile of patients with Klippel-Trenaunay-Weber syndrome. METHODS: Medical records of 58 patients followed at the lymphatic disease and angiodysplasia outpatient clinic for the discipline of Vascular Surgery at the School of Medical Sciences of Santa Casa de São Paulo were reviewed. RESULTS: The disorder affected males and females equally (30 males and 28 females). The mean age of patients under treatment was 12.8 years. In most cases, the syndrome had been diagnosed in childhood, with Port wine stain as the first sign noticed by the family at birth or during the first year of life. The most frequently reported symptom was debilitating pain usually associated with symptoms of venous stasis. The CEAP classification was C0 and C1 for younger patients and C4-C6 for most older patients. Arteriovenous fistulas were diagnosed in 8.5 percent of cases. Positive family history was reported by only 6.8 percent of patients. CONCLUSION: Klippel-Trenaunay and Parkes Weber syndromes are different presentations of a same disorder and they can be studied as one, Klippel-Trenaunay-Weber syndrome. Childhood is the optimal moment to identify affected patients and to reduce progression of venous insufficiency and bony and soft tissue hypertrophy. Compression should be indicated for all affected patients to reduce progression of peripheral venous disease.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Klippel-Trenaunay-Weber Syndrome/diagnosis , Heart Defects, Congenital/complications , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/pathology , Lower Extremity
6.
Acta odontol. venez ; 45(2): 273-275, 2007. ilus
Article in Spanish | LILACS | ID: lil-499552

ABSTRACT

El objetivo del trabajo es exponer nuestra experiencia en el tratamiento quirúrgico de una fístula arteriovenosa del labio inferior de una paciente de 15 años de edad, producida por una mordida. La paciente fue diagnosticada en su inicio como un Hemangioma traumático, el cual fue tratado con esteroide y exeresis quirúrgica. A los 4 años apareció con una tumoración más voluminosa, se realizó disección de la carótida externa y arteriografía carotídea la cual diagnosticó fístula arteriovenosa, se realizó ligadura de la facial y de los vasos venosos, para aislarla de la circulación. Se inyectaron 4 cc de betametazona en la tumoración, posteriormente se inyectaron 4 inyecciones adicionales con intervalos e 3 semanas, a los tres meses de la ligadura de los vasos sé realizó la exéresis de la fibrosis de la tumoración. En estos momentos la paciente tiene 5 años de la última intervención, no presentando recidiva. Se destaca la importancia del estudio angiográfico para él diagnóstico y tratamiento de esta entidad patológica, que es poco frecuente.


The objetive of this paper is to expose our experience in the surgical treatment of an arteriovenous fistulae of the lower lip in 15 years- old patien, caused for humanbite. The patient was first diagnosed as traumatic hemangioma, treated with steroids and surgical removal. Four years later a voluminous tumor appeared, a dissection of the external carotid and a carotid angiography was performed and an arteriovenous fistulae was diagnosed. A ligament of the facial and venous vasseles was performed to isolete them from circulation. 4cc of Betametaza were inyected inside of tumors, and later 4 additional doses with 3 week of interval. Three months after the ligament a surgical removal of the fibrous tumor was done. At present, after 5 years of the last operation, the patient is getting well, with no recidive. The importance of the angiography study has been put into evidence, to diagnose and treat this athology, which is not so common.


Subject(s)
Humans , Female , Arteriovenous Fistula/surgery , Arteriovenous Fistula/pathology , Hemangioma/surgery , Carotid Artery, External/surgery , Oral Surgical Procedures/methods
7.
Neurol India ; 2006 Jun; 54(2): 202-4
Article in English | IMSEAR | ID: sea-121868

ABSTRACT

The histological features of arterialized medullary vein (MV) in spinal dural arteriovenous fistulas (SDAVF) were studied in five consecutive patients who presented with progressive congestive myelopathy. Retrograde venous filling on preoperative angiography was recognized as being severe in 3 cases and moderate in 2 cases. Direct intradural interruption of the arterialized MV was performed in all patients. The arterialized MV was sampled and examined histologically to determine the percentage of the hyperplasia of venous wall (hypertrophic ratio). Histological examination of arterialized MV showed that hypertrophic alteration of venous wall structure was due to hyperplasia of elastic fibers, ranging from 41 to 82%. Patients with angiographically severe venous hypertension tended to have a higher hypertrophic ratio than patients with moderate venous hypertension. Our observations support the clinical concept that long-standing arterial stress in the spinal venous circulation causes histological alterations of spinal vascular structure associated with the progression of venous hypertension. We suggested that possibly the histological parameter can be used for predicting neurological recovery after occlusion of the fistulas.


Subject(s)
Angiography , Arteries/pathology , Arteriovenous Fistula/pathology , Cerebrovascular Circulation/physiology , Gait Disorders, Neurologic/etiology , Humans , Magnetic Resonance Imaging , Male , Medulla Oblongata/blood supply , Middle Aged , Spinal Cord/pathology , Veins/pathology
8.
Radiol. bras ; Radiol. bras;37(6): 397-403, nov.-dez. 2004. ilus, tab
Article in Portuguese | LILACS | ID: lil-393287

ABSTRACT

OBJETIVO: Este estudo tem por finalidade obter um método diagnóstico angiográfico alternativo que possa ser utilizado em doentes com alto risco ao uso de meio de contraste iodado. MATERIAIS E MÉTODOS: Foram estudados 26 doentes com insuficiência renal crônica, que tiveram suas fístulas analisadas, submetidos à angiografia digital - na primeira fase, utilizando o meio de contraste iodado e, na segunda fase, gás carbônico como meio de contraste, com registro em filme angiográfico. A angiografia foi avaliada por dois médicos independentes, que analisaram a opacificação, o diagnóstico radiológico e o calibre dos vasos; a análise comparativa das medidas da artéria, da veia e da freqüência respiratória antes e após a injeção de contraste foi realizada pelo autor. RESULTADOS: Os resultados obtidos pela analise estatística utilizando coeficiente kappa apresentaram concordância entre os dois médicos, referente à opacificação, de 0,3217, referente ao diagnóstico radiológico, de 0,5583, e referente à analise de calibre dos vasos, de 0,4298. A análise das medidas da artéria e da veia não apresentou diferença significativa pela medida de posição e dispersão, mostrando concordância na regressão linear, com p-valor de 0,3657 e de 0,2041; para a freqüência respiratória, as análises das medidas de posição e dispersão não apresentaram diferença significativa. CONCLUSÃO: Concluímos ser este método uma alternativa no estudo angiográfico em pacientes com antecedente alérgico ou com risco nefrotóxico.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/pathology , Renal Insufficiency , Angiography , Contrast Media , Contrast Sensitivity
9.
Article in English | WPRIM | ID: wpr-92737

ABSTRACT

The case of a cyanotic infant with a rare combination of atypical pulmonary artery sling, imperforate anus, absence of the left kidney, interruption of the inferior vena cava, left side hemihypertrophy and diffuse-type pulmonary arteriovenous fistula is described. The clinical features were confusing, because of compounding abnormalities involving the respiratory tract and pulmonary circulation. The diagnostic approach to the etiology of cyanosis is discussed and the embryonic origin of pulmonary artery sling is reviewed.


Subject(s)
Humans , Infant , Male , Arteriovenous Fistula/diagnostic imaging , Arteriovenous Fistula/pathology , Pulmonary Artery/pathology
10.
Rev. venez. cir ; 49(3/4): 109-16, jul.-dic. 1996. ilus, tab
Article in Spanish | LILACS | ID: lil-193621

ABSTRACT

Se realizó un estudio prospectivo en la Unidad de Nefrología de Hospital Miguel Pérez Carreño (MPC), donde se analizaron los resultados de 65 pacientes confeccionándose 78 fístulas en un lapso de tiempo comprendido desde septiembre de 1993 a abril de 1994. Fueron excluidos de este trabajo los pacientes quienes requirieron de accesos vasculares protésicos. El 67,69 por ciento correspondió al sexo masculino y, el 32,31 por ciento al femenino. La población de nuestro universo mayormente afectado estuvo entre los 35 y 64 años de edad, representando el 60 por ciento. La patología primaria correspondió a la diabetes (23,07 por ciento), HTA (21,53 por ciento), litiasis renal (13,85 por ciento); otras fueron glomerulonefritis (9,23 por ciento), medicamentosas (4,61 por ciento), riñón poliquístico (1,53 por ciento). Siete de nuestros pacientes no representaban criterios para algún tipo de procedimiento de diálisis, 2 se trataban con diálisis peritoneal y 56 en hemodiálisis. Las complicaciones correspondió al 9,23 por ciento (6 casos); representadas en edema importante del miembro intervenido (3,07 por ciento), Síndrome de Robo (1,53 por ciento), y los otros 3 casos fueron considerados como leves. De los 65 casos se obtuvo un éxito de 49 pacientes (75,38 por ciento). Hubo necesidad de reinvertir en las primeras dos semanas a 16 (24,62 por ciento) de los cuales sólo 13 se reintervinieron, obteniéndose un desarrollo satisfactorio en 11 pacientes, en quienes se confeccionó nueva fístula, aumentando el porcentaje de funcionamiento en el 92,30 por ciento de los pacientes en total. Consideramos que se obtuvo un fracaso en 5 casos (7,7 por ciento).


Subject(s)
Humans , Male , Female , Arteriovenous Fistula/pathology , Arteriovenous Fistula/surgery , Renal Insufficiency, Chronic/pathology , Renal Insufficiency, Chronic/prevention & control
11.
Arq. bras. cardiol ; Arq. bras. cardiol;66(6): 353-355, Jun. 1996.
Article in Portuguese | LILACS | ID: lil-319268

ABSTRACT

The case of a six-day-old neonate admitted in an emergency situation because of dyspnea and increasing cyanosis is reported. Despite abnormal opacification on the chest X-ray and left ventricular overload on the electrocardiogram and echocardiogram, features compatible with the disease, the diagnosis of massive pulmonary arteriovenous fistula affecting the whole left superior lobe, was made possible only after necroscopic examination


É relatado o caso de um neonato com seis dias de vida, encaminhado em caráter de urgência devido à cianose e dispnéia. Apesar da opacificação pulmonar na radiografia simples do tórax e da sobrecarga de câmaras esquerdas no eletrocardiograma e ecocardiograma, dados sugestivos da lesão, o diagnóstico de fístula arteriovenosa pulmonar maciça, envolvendo todo o lobo superior esquerdo, foi estabelecido, somente, através do estudo necroscópico


Subject(s)
Humans , Male , Infant, Newborn , Pulmonary Artery , Pulmonary Veins , Arteriovenous Fistula/congenital , Arteriovenous Fistula/pathology
12.
Article in English | WPRIM | ID: wpr-126073

ABSTRACT

Arteriovenous fistulas of the extracranial vertebral artery are rare. The authors report a case of a spontaneous arteriovenous fistula of the extracranial vertebral artery presenting as an osteolytic lesion at the body of the axis. The patient presented with headache and posterior neck pain. The fistula was obliterated by an endovascular trapping.


Subject(s)
Adult , Humans , Male , Arteriovenous Fistula/pathology , Axis, Cervical Vertebra/pathology , Follow-Up Studies , Osteolysis/pathology , Vertebral Artery/pathology
13.
Arequipa; UNSA; ago. 1995. 89 p. ilus.
Thesis in Spanish | LILACS | ID: lil-191969

ABSTRACT

El presente trabajo se trata de un estudio retrolectivo en pacientes con el diagnóstico de Aneurisma Arteriovenoso Cerebral, también denominados Malformaciones arteriovenosas congénitas cerebrales hospitalizados en el Servicio de Neurocirugía del Hospital Regional Honorio Delgado de Arequipa en los años de 1961 a 1994; se registraron 20 casos, que guarda relación con otros estudios. También en este estudio se realizó con respecto al tema. Se utilizó el método estadístico descriptivo. La edad de aparición de la sintomatología varió desde los 30 años. No se encontró diferencia por sexo. En cuanto a la forma clínica de presentación preponderante se tiene a la cefálea en un 70 por ciento de casos, luego se presentó la hemorragía en un 65 por ciento de casos. En relación al procedimiento diagnóstico de mayor uso se tiene a la arteriografía cerebral, y por medio de ello se evidenció que el vaso arterial de mayor compromiso fue la cerebral anterior y luego la cerebral media, que en conjunto abarcan el 70 por ciento del total de los casos. El tratamiento quirúrgico más empleado lo constituyó la excéresis total, se realizó en seis pacientes, de ellos todos tuvieron una buena evolución, tal es así que al momento del alta mostraron una recuperación total


Subject(s)
Humans , Clinical Diagnosis , Diagnostic Techniques, Surgical , Arteriovenous Fistula/surgery , Arteriovenous Fistula/pathology , Intracranial Aneurysm/diagnosis , Intracranial Aneurysm/pathology , Intracranial Aneurysm/surgery , Neurology
14.
CCS ; 13(3): 106-11, jul.-set. 1994. ilus
Article in Portuguese | LILACS | ID: lil-200969

ABSTRACT

Os autores relatam dois casos de fístula artério-venosa pulmonar (FAVP), um dentre estes associado à síndrome de Rendu-Osler-Weber com múltiplas fístulas, o outro secundário à tuberculose pulmonar. Discutem os achados clínicos e laboratoriais, enfatizando os meios para estabelecer diagnóstico diferencial com outras patologias causadoras FAVP secundária. Discorreu sobre a escolha terapéutica, apontando opçöes emboloterapia ou ressecçäo cirúrgica, confrontando-os com a literatura


Subject(s)
Humans , Male , Adult , Middle Aged , Arteriovenous Fistula/congenital , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/pathology , Telangiectasia, Hereditary Hemorrhagic , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/pathology
15.
Arq. bras. cardiol ; Arq. bras. cardiol;58(3): 199-201, mar. 1992. ilus
Article in Portuguese | LILACS | ID: lil-122181

ABSTRACT

Paciente coronariopata, 61 anos, portador da fístula coronária artério-venosa (FCAV) submetido à angioplastia coronária de um grande ramo diagonal, optando-se na ocasiäo pela näo intervençäo na FCAV. As FACV säo anomalias geralmente congênitas que, dependendo de sua severidade, podem levar o paciente a apresentar: insuficiência cardíaca congestiva, endocardite infecciosa, angina do peito, secundária ao fenômeno do "roubo coronário", podendo ocorrer também, na evoluçäo a ruptura da fístula. Quando o "shunt"provocado pelas FCAV é significativo, o tratamento recomendado é o cirúrgico


Congenital coronary arteriovenous fistulae are commonly associated with complications which include congestive heart failure, bacterial endocarditis, angina pectoris, secondary to "coronary steal" phenomenon and fistula rupture. Convencional treatment of large coronary arteriovenous fistalae is surgical ligation. In this report we describe the duta and therapeutic approach of a patient with a severe coronary stenosis in a large diagonal branch in whom PTCA was successfully conducted, while, in this opportunity no embolization of the fistula was periormed


Subject(s)
Humans , Male , Middle Aged , Angioplasty, Balloon , Coronary Vessels/pathology , Arteriovenous Fistula/therapy , Myocardial Ischemia/etiology , Constriction, Pathologic/complications , Constriction, Pathologic/therapy , Arteriovenous Fistula/complications , Arteriovenous Fistula/pathology
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