Arteriovenous fistula aneurysm

Penetrating and non-penetrating neck injuries are more likely to damage the carotid than the better protected vertebral artery. The vertebral artery appears to be more vulnerable to rotational and hyperextension injuries of the neck, particularly at the level of the atlas and axis. Laceration, dissection and intimal tears may be complicated by thrombosis and then embolism and, therefore, ischemic stroke at the time of the injury or some days or even weeks after the injury. Later stroke may be a consequence of the formation of a traumatic aneurysm, arteriovenous fistula or a fistula between the carotid and vertebral arteries (Davis and Zimmerman 1983). 

Arterial bruit A systolic rushing sound synchronized with the heart beat indicates increased arterial blood flow. This often barely audible sound is easier to discern if one listens for arterial bruit and feels the patient s pulse at the same time. It is sometimes heard where aneurysm or stenosis is present in large arteries (e.g. coeliac artery, hepatic artery) as well as in arteriovenous malformations, highly vascularized liver tumours, pronounced acute alcohol hepatitis, 1-2 days after liver biopsy resulting from temporary arteriovenous fistula, or in twisted arteries in cirrhosis. It is seldom found in healthy persons. (10, 13, 44)... 

Aneurysm of the hepatic artery Arteriovenous fistula Calcification of the hepatic artery Cavernous haemangioma Echinococcus cysts (s. fig. 25.18)... 

Therapeutically, cellulose acetate has been used to treat cerebral aneurysms, and also for spinal perimedullary arteriovenous fistulas. 

Klein GE, Szolar DH, Karaic R et al (1996) Extracranial aneurysm and arteriovenous fistula embolization with the Guglielmi detachable coil. Radiology 201 489-494... 

Quinones D, Duckwiler G, Gobin PY et al (1997) Embolization of dural cavernous fistulas via superior ophthalmic vein approach. AJNR Am J Neuroradiol 18 921-928 Ratliff J, Voorhies RM (1999) Arteriovenous fistula with associated aneurysms coexisting with dural arteriovenous malformation of the anterior inferior falx. Case report and review of the literature. J Neurosurg 91 303-307 Reinges MH, Thron A, Mull M et al (2001) Dural arteriovenous fistulae at the foramen magnum. J Neurol 248 197-203... 

Lemaire JM, Dondelinger RF (1994) Percutaneous coil embolization of iatrogenic femoral arteriovenous fistula or pseudo-aneurysm. Eur J Radiol 18 96-100... 

Hemorrhage / hematoma / false aneurysm Arteriovenous fistula Nerve damage... 

The surgical treatment of aneurysms in BD should be considered carefully since the operative morbidity and mortality rates of surgical interventions for vascular involvement are very high. CompUcations include anastomotic aneurysm, arteriovenous fistulas, and thrombus (6). Lobectomy and pneumonectomy should be reserved only for urgent cases with massive hemoptysis. Other treatment modalities have involved embolization, but this procedure carries a risk of bleeding and other hazards (43). 

Feijoo-Cano C Giant true aneurysm of the radial artery following ligation of an arteriovenous fistula for haemodialysis. Neffologia 2012 32 404M06. 

Considerable morbidity exists when dealing with vascular access (VA) creation. Native arteriovenous fistulae (AVF) are the desired VA for patients on dialysis due to their comparably low morbidity and fairly good long-term patency. However, they are also at risk for nonmaturation, stenosis, thrombosis, infection, aneurysm formation, and steal syndrome [ 1 ]. Fistula success is dependent on the center of access creation. Hence, the vascular surgeon s skills and decisions are key [2]. Furthermore, success is also determined by preoperative, technical, and postoperative factors that will be discussed in this chapter (fig. 1). 

Arteriovenous malformations present most commonly with signs consistent with a space-occupying lesion or seizures and consist of an abnormal fistulous connection(s) between one or more hypertrophied feeding arteries and dilated draining veins (Clatterbuck et al. 2005) (Fig. 7.5). The blood supply is derived from one cerebral artery or, more often, several, sometimes with a contribution from branches of the external carotid artery. Arteriovenous malformations vary from a few millimeters to several centimeters in diameter. Approximately 15% are associated with aneurysms on their feeding arteries. Some grow during life but a few shrink or even disappear, and some are multiple. These fistulae occur in or on the brain, or in the dura of the intracranial sinuses. 

Other lesions do not belong to this classification either. As stated above, intra-renal arteriovenous (or arterio-calyceal) fistulas or pseudo-aneurysms represent an excellent indication for super-selective angiography. Adrenal hematoma is frequently associated the diagnosis by CT is straightforward, the endocrine prognosis is usually excellent, and calcification is frequent on follow-up. 

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