Case Of Traumatic Arteriovenous Fistula Research Articles

Hybrid Management for Traumatic Iliac Arteriovenous Fistula

Traumatic arteriovenous fistulas are usually the evolution of non-treated contiguous arterial and venous injuries inflicted by firearm projectiles. As time passes, these fistulas can lead to systemic and local repercussions. Endovas-cular management offers great benefit in reducing the risks of open surgery for correcting these fistulas, but unfor-tunately some endovascular resources are not always available.In this situation, a hybrid management offering an endovascular strategy to control bleeding, while allowing an open disconnection of the affected artery and vein, may be useful in dealing with these complex injuries. In this article, the authors report a case of traumatic arteriovenous fistula between the common iliac vessels, managed with a hybrid strategy and make comments about practical issues regarding planning the open part of the procedure and anticipating possible complications when treating such injuries.

Traumatic Common Carotid-jugular Fistula In A 6-year-old Child: Rare Cause Of Pulsatile Neck Mass

Background: Traumatic common carotid artery-jugular vein fistula is an uncommon clinical entity that may follow penetrating neck injury. It is rarely seen in children. It usually presents with a pulsatile neck mass following a history of trauma to the neck. It may present with pulsatile mass, thrill on palpation and murmurs on auscultation. There may be a neurologic deficit, which may vary from hemiparesis to hemiplegia. We present a case of traumatic arteriovenous fistula that presented as pulsatile anterior neck swelling in a school child. Case Presentation: A 6 year old male child, presented with a 3 days history of penetrating gunshot injury to the right side of the neck, as a result of accidental discharge from a gun during a marriage ceremony. The patient said to have bled profusely from the site of injury and had transient loss of consciousness. Examination revealed a healing wound and a slight swelling on the right side of the neck just anterior to the anterior border of the sternocleidomastoid muscle. The mass was pulsatile, with palpable thrill and bruit on auscultation. Colour doppler ultrasound demonstrated an abnormal connection with abnormal blood flow from the right common carotid artery to the right internal jugular vein. He was successfully treated surgically by neck exploration, excision of the fistula, and repair of defects in both vessels. Conclusions: Traumatic carotid-jugular fistula following gunshot injury is rarely seen in children. Guns should not be used or left unattended to in crowds so as to forestall future occurrence of accidental discharge that could lead to avoidable injuries. We recommended strict adherence to the rules and regulations guarding the use of firearms by civilians.

Traumatic Arteriovenous Fistula of the Internal Mammary Vessels

An uncommon case of traumatic arteriovenous fistula of the left internal mammary artery following penetrating chest trauma is presented. The patient developed a left parasternal machinery murmur six days after thoracotomy to repair a pericardial tamponade after a penetrating left parasternal stab wound. Selective digital subtraction angiography revealed pseudoaneurysm formation with fistulous connection of the left internal mammary artery to the adjacent vein. The fistula was successfully occluded with coil embolization.

Diagnosis and management of acute traumatic arteriovenous fistula

Acute arterial injuries are often complicated by the development of an arteriovenous fistula (AVF). In the acute setting, an AVF may present at the same time as the arterial injury. A case of traumatic AVF in the thigh that presented with normal neurovascular examination findings is reported. AVF was diagnosed by duplex scan and managed promptly. The authors suggest that duplex imaging together with arteriography, where appropriate, should be performed routinely when penetrating wounds are in close proximity to major vessels despite a normal clinical neurovascular examination.

Transvenous Embolization and Stent Placement for an Internal Iliac Arteriovenous Fistula with Central Iliac Vein Occlusion

The authors present a case of traumatic arteriovenous fistula of the internal iliac vessels treated with attempted surgical ligation of the common iliac artery and external iliac artery. The fistula persisted after the operation, and because the patient received no further treatment for the following 6 years, a venous outflow occlusion also developed as a result of high-flow angiopathy. Because the arterial route was eliminated at previous surgery, the fistula and venous occlusion were percutaneously treated via a transvenous approach.

Spindle cell haemangioendothelioma in an arteriovenous fistula of the ring finger after blunt trauma

We present a case of traumatic arteriovenous fistula of the palm and ring finger, which posed management dilemmas and eventually necessitated ray amputation. Subsequent histology revealed a spindle cell haemangioendothelioma that had developed within the fistula. We report the clinical features and management of this patient.

Traumatic Arteriovenous Fistula

Traumatic arteriovenous fistula in the head and neck may present a difficult problem in management. We present a surgical case of traumatic arteriovenous fistula between the right subclavian artery and internal jugular vein with false aneurysm formation. Traumatic injury of the subclavian artery causing arteriovenous fistula with false aneurysm is a serious surgical emergency with appreciable morbidity and mortality that requires early recognition and prompt surgical intervention.(Ann Thorac Surg 1997;63:1792–4)

Percutaneous embolization of an arteriovenous fistula of the internal mammary pedicle following sternal wire insertion

A case of traumatic arteriovenous fistula and false aneurysm of the internal mammary artery was encountered following sternal wire insertion during cardiac surgery. The diagnosis was suspected by echo-doppler and confirmed by arteriography allowing percutaneous embolization using cyanoacrylate in the same setting.

Arteriovenous Fistula with False Aneurysm of the Inferior Medial Geniculate Artery A Complication of Total Knee Arthroplasty

Two cases of traumatic arteriovenous fistula with false aneurysm of the inferior medial geniculate artery are reported as a complication of total knee arthroplasty. Both cases were diagnosed within the first two months following the knee surgery. Diagnosis in both cases was confirmed by arteriography. Surgical excision of this lesion with ligation of the inferior medial geniculate artery resolved both of these complications. Strict hemostasis in the region of the inferior medial geniculate artery following subperiosteal release of the medial ligaments in total knee arthroplasty should prevent this complication.

Traumatic arteriovenous fistula of the thumb after blunt trauma: A case report

Arteriovenous malformations in the hand are uncommon and traumatic arteriovenous fistulas that result from hand-penetrating injuries are rare. We report a case of traumatic arteriovenous fistula of the thumb subsequent to blunt trauma.

Traumatic Arteriovenous Fistula of the Superior Mesenteric Vessels

A case of traumatic arteriovenous fistula of the superior mesenteric vessels is added to a collective review of 16 previous cases. Nausea, vomiting, cramping abdominal pain, diarrhea, abdominal thrill and bruit were usually present. Arteriography was diagnostic. Four patients operated upon immediately or within 11 hours after penetrating abdominal trauma had superior mesenteric arteriovenous injuries repaired; the remainder had a mesenteric vascular injury missed at initial laparotomy. The location of the fistula determined the method of repair. Spontaneous obliteration occurred in one patient. In two of the three deaths, portal hypertension was persent and a fistula was discovered at autopsy; the other occurred 3 months after massive bowel resection. Thorough exploration of hematomas and lacerations of the mesentery will minimize or eliminate subsequent formation of an arteriovenous fistula.

Traumatic arteriovenous fistula of the superficial temporal artery. Report of a case.

A case of traumatic arteriovenous fistula of the superficial artery following a laceration of the frontotemporal scalp is reported. The fistula was demonstrated angiographically by means of selective percutaneous external carotid arteriography.

Acquired arteriovenous fistulas complicated by endarteritis, and endocarditis lenta due to Streptococcus faecalis.

THE occurrence of an acquired arteriovenous fistula complicated by both bacterial endocarditis and endarteritis is unusual. Although 20 cases of traumatic arteriovenous fistula with associated bacterial endarteritis have been reported,1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 only 7 of these were complicated by coexistent endocarditis.1 2 3 4 5 6 7 The aortic valve was the site of the endocarditis in all cases. Heretofore, Streptococcus viridans has been found to be the cause of the septicemia. Although arteriovenous fistula with endarteritis has occurred at variable sites, it has uniformly involved the femoral or closely associated vessels in cases complicated by both endarteritis and endocarditis. Among these patients, therapy was supportive except in . . .

ARTERIOVENOUS FISTULA BETWEEN THE RIGHT COMMON ILIAC ARTERY AND THE INFERIOR VENA CAVA

Numerous cases of traumatic arteriovenous fistula in which cure was obtained by surgical measures have been recorded in the literature. The abnormal physiologic effects produced by this condition have been thoroughly studied and reported by Reid, 1 Holman, 2 Makins 3 and Matas, 4 to whose writings the reader may refer. Large fistulas involving the major arteries and veins when allowed to persist result in gradual cardiac hypertrophy, dilatation and finally failure, and if they are not corrected death results. The first symptom that may develop is gradually increasing dyspnea on exertion. This is a warning of impending cardiac decompensation that should not be ignored. The diagnosis of an acquired arteriovenous fistula is not difficult in the majority of cases. In an extremity a pulsating expansile mass is found in the region of the fistula. The limb frequently enlarges and on its surface many large engorged pulsating veins are seen.

ARTERIO‐VENOUS (CAROTID‐JUGULAR) FISTULA AND CAROTID ANEURYSM

Summary.A case of traumatic arterio‐venous fistula involving the left carotid artery and internal jugular vein, with an associated saccular aneurysm, is described. The vascular complications and their response to operation are recorded.

The local and systemic effects of arterio-venous fistula on the circulation in man

1. 1. Two cases of traumatic arterio-venous fistula were studied before and after surgical operation. Both patients showed the characteristic local signs of the condition, and the first patient presented the classical phenomena of the effect on the general circulation. 2. 2. In the first patient estimations of the cardiac output were performed, and although the applicability of the method is somewhat limited in this condition, the measurements showed no marked change upon compression of the aneurism and a slight tendency for a decrease following operation. The velocity of blood flow in this subject showed no change at any time. The blood volume was normal. 3. 3. Evidence was presented of an arteriolar dilatation in the surrounding region of the arterio-venous aneurism in the second patient. 4. 4. It was suggested that in certain cases of arterio-venous aneurism of marked extent, the arteriolar dilatation may be generalized. Like-wise, in aortic insufficiency such an arteriolar dilatation may exist. This would explain the capillary pulsation and to a certain extent other of the peripheral circulatory phenomena which are observed both in arterio-venous fistula and aortic regurgitation.