Traumatic pulmonary arteriovenous fistula.

The first case of traumatic pulmonary arteriovenous fistula in the English literature is reported. The case is reported to alert thoracic surgeons to the possibility of this lesion following penetrating chest injuries.     

Traumatic arteriovenous fistula. Case report

A young man with a fistula between the right femoral artery and vein due to bullet wound presented 6 years later with exertional dyspnea and palpitations and venous insufficency of the right leg. Angiography showed a wide (greater than 20 mm) arteriovenous fistula. Moderate cardiac hypertrophy and cardiac output 14.8 l/min were found. During division and closure of the fistula, 8 l/min flow was measured in the right external iliac artery. The cardiac symptoms disappeared immediately and the venous insufficiency gradually.     

Posttraumatic splenic pseudoaneurysm and arteriovenous fistula: diagnosis by computed tomography angiography and treatment by transcatheter embolization

The current treatment of splenic injury in children is conservative. The common concern with nonoperative management of splenic injury involves increased risk of posttraumatic splenic complications. Computed tomography angiography is a noninvasive and useful technique for the detection of the vascular abnormalities in conservatively managed splenic injuries. We present a case of posttraumatic splenic pseudoaneurysm and arteriovenous fistula (AVF) in a 12-year-old boy, which were prediagnosed by color Doppler ultrasound and consecutively shown by computed tomography angiography. The treatment of splenic AVF is indicated to avoid portal hypertension, high output cardiac failure, and related complications. To preserve the splenic immune function and to avoid the risk of surgery and splenectomy complications, splenic pseudoaneurysm and AVF were successfully occluded by transcatheter embolization.     

Traumatic arteriovenous fistula: a complication of amniocentesis.

Fetal injury is a potential complication of amniocentesis. We report the case of an infant who had an isolated arteriovenous fistula between the popliteal artery and vein that resulted from amniocentesis. Unlike the usual congenital arteriovenous communications that are multiple and difficult to treat, this case was completely cured by division of the fistula and vascular repair. This case emphasizes that newborns and infants who have had invasive prenatal interventions such as amniocentesis should be identified and the possibility of fetal injury be considered when evaluating their clinical signs and symptoms.     

Paravertebral arteriovenous fistula treated by endovascular coil embolization

A 41-year-old man, without underlying health problems or traumatic episodes, presented with a rare paravertebral arteriovenous fistula (AVF) causing radiculopathy manifesting as gradually progressive right grip weakness, and right thumb, index, and middle finger numbness. Digital subtraction angiography revealed a high flow, single hole paravertebral AVF fed by the right thyrocervical trunk that drained into the epidural venous plexus. The patient underwent endovascular embolization of the AVF via the transarterial approach. The fistula was completely occluded by coil embolization. Postembolization, clinical symptoms improved and 6-month follow-up angiography showed no recurrence of the fistula. Paravertebral AVF is a rare vascular malformation occurring outside the dura mater, fed by dural or epidural branches, and draining primarily into the epidural venous plexus. Paravertebral AVF is usually asymptomatic because of a "reflux-impending mechanism" within the dural sleeves that prevents retrograde drainage into the perimedullary veins. However, in the present case, mechanical compression of the radicular nerve due to a dilated epidural venous plexus resulted in neurological symptoms. We conclude that endovascular surgery is an effective treatment strategy for paravertebral AVF.     

Transcatheter embolization of renal arteriovenous fistula

A patient with malignant hypertension and acute renal failure underwent percutaneous renal biopsy which resulted in the creation of an arteriovenous fistula that communicated with the renal pelvis. Successful segmental embolization with gelatin sponge (Gelfoam) was achieved via a transcatheter approach.     

Giant high-flow renal arteriovenous fistula treated by percutaneous embolization

We report the case of a giant renal arteriovenous fistula after renal biopsy in a 30-year-old man with hematuria and hypertension. We performed percutaneous endovascular embolization using macrocoils to exclude the fistula. The patient made an uneventful recovery with no further hematuria and progressive reduction of blood pressure. Follow-up by digital subtraction angiography (DSA) at 6 months showed complete occlusion of the fistula with no evidence of renal parenchymal infarction. Although giant renal arteriovenous fistulas are generally treated by nephrectomy, this case shows that embolization is a reasonable alternative to surgery.     

Successful transarterial embolization of idiopathic renal arteriovenous fistula.

A case of idiopathic renal arteriovenous fistula in a 46-year-old woman presenting intensive right renal colic associated to massive hematuria is reported. The renal arteriography confirmed the diagnosis and embolization of the fistula was performed. The transarterial embolization was successful no recurrence is observed after one year follow-up.     

Traumatic superior mesenteric arteriovenous fistula. A case report

In a case of traumatic superior mesenteric arteriovenous fistula resulting from a stab wound in the abdomen clinical signs of high-output cardiac failure or portal hypertension were absent. Selective angiography was useful in confirming and locating the fistula. The patient made a good recovery after resection of the aneurysm and fistula and insertion of a prosthetic graft.     

Traumatic arteriovenous fistula of the posterior inferior cerebellar artery treated with endovascular coil embolization: case report

BACKGROUND: High-flow intracranial arteriovenous (AV) fistulas associated with giant varices are rare lesions. These varices can present with symptoms from mass effect, spontaneous hemorrhage, and seizures to cardiac failure. Direct AV fistulas of the posterior inferior cerebellar artery (PICA) are extremely rare lesions, with only two cases reported in the literature. CASE DESCRIPTION: The authors present an unusual case of a 25-year-old male with a direct AV fistula of the PICA that resulted from a fracture of the occipital condyle. This high-flow AV fistula drained into a giant varix of the vein of the lateral recess that compressed the brainstem, resulting in a Wallenberg syndrome. The patient underwent embolization of the proximal PICA feeding the fistula with a Guglielmi detachable coil (GDC), which resulted in thrombosis of the varix. A postembolization angiogram showed occlusion of the PICA AV fistula and draining varix. A computed tomography (CT) scan performed at a 10-month follow-up visit showed dramatic decompression of the brainstem. Although the patient continued to have some sensory changes secondary to Wallenberg syndrome, he was otherwise doing well neurologically. CONCLUSION: The treatment of this lesion is difficult because of its location near the brainstem. Postocclusion edema or hemorrhage can result in mass effect and life-threatening brainstem compression. Our patient, whose AV fistula was caused by trauma, was treated effectively with GDC embolization.     

Traumatic spinal perimedullary arteriovenous fistula: a case report

Spinal perimedullary arteriovenous fistula, a subtype of spinal arteriovenous malformation, is generally considered to be a congenital lesion by maldevelopment of the spinal vascular system. However, several cases of perimedullary arteriovenous fistula had been reported in the literature, which were thought to be acquired lesions. We presented a case of perimedullary arteriovenous fistula, which was believed to be derived from spinal cord trauma. The etiology and pathophysiology of this case were discussed, and it might provide further insight into the pathogenesis of such lesions.