• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.409-417
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• 2020

Purpose To evaluate the safety and efficacy of the percutaneous manual aspiration thrombectomy technique to treat thrombotic occlusion of native arteriovenous fistulas. Materials and Methods A retrospective review of 20 patients who underwent percutaneous manual aspiration thrombectomy for native thrombotic arteriovenous fistula occlusion from March 2012 to December 2017 was performed. We evaluated technical and clinical success rates and complications. The primary and secondary patency rates were calculated using the Kaplan-Meier analysis. Results Percutaneous manual aspiration thrombectomy was performed in 20 patients (n = 20) with concomitant balloon angioplasty. The overall technical and clinical success rates were both 85% (n = 17). The native arteriovenous fistulas, based on their site, were the left radiocephalic (n = 13), left brachiocephalic (n = 4), and right radiocephalic (n = 3) fistulas. An underlying stenosis was detected in the juxta-anastomotic venous site (n = 16), outflow draining vein (n = 12), and central vein (n = 4). The primary and secondary patency rates at 1, 3, 6, and 12 months were 100%, 70.6%, 70.6%, and 56.5% and 100%, 94.1%, 94.1%, and 86.9%, respectively. There were no complications associated with procedure. Conclusion Percutaneous manual aspiration thrombectomy is a safe and effective method to treat thrombotic native arteriovenous fistula occlusion.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.877-881
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• 1988

A coronary arteriovenous fistula represents an abnormal communication from a coronary artery that may enter any cardiac chamber, a pulmonary artery, the coronary sinus, the superior vena cava or the pulmonary vein. We had a successful experience with 46 year-old male who complained exertional dyspnea[NYHA classification II] and anginal pain since 5 years ago. In intensive study of cardiac catheterization and coronary cineangiography, multiple bilateral coronary arteriovenous fistulas and mitral stenoinsufficiency with left atrial thrombi were recognized. The coronary arterio-venous fistula of left coronary artery was revealed large tortuous aberrant vessels that were connected between just distal portion of first diagonal branch of left anterior descending artery and main pulmonary artery. Other fistula was small tortuous vessel which was originated from left atrial branch of left circumflex artery, was drained into left atrium. The fistula of right coronary artery was communicated conal branch of right coronary artery to main pulmonary artery. But there was no 0y step-up in the right cardiac catheterization. The operative procedure were suture-ligation of draining orifice of coronary arteriovenous fistula in main pulmonary artery, mitral valve replacement[Ionescu-Shiley 25mm] with removal of left atrial thrombi and plication of left atrium under the extracorporeal circulation. The postoperative course was uneventful without any complication and discharged without problem at 17th postoperative days.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.118-124
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• 2017

Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.712-718
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• 2022

Diploic arteriovenous fistulas (AVFs) or intraosseous dural AVFs are rare arteriovenous shunts. A diploic AVF is formed between a meningeal artery and an intraosseous diploic vein or the transosseous emissary vein, and the nidus is located exclusively within the bone. Currently, endovascular embolization with a transvenous approach is considered the treatment of choice for most dural AVFs. However, in the absence of an accessible venous channel, an alternate treatment approach should be considered. Herein, we report a case of a diploic AVF that was treated using embolization with transosseous direct cannulation.

• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.411-413
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• 2007

We report on a diabetic 52-year-old man who complained ocular floating sensation, headache and dizziness, in whom a left parieto-occipital dural ateriovenous fistulas [DAVFs], fed by bilateral superficial temporal arteries and occipital artery, drained into the cortical vein of the left parieto-occipital convexity. Because the patient's chief complaint was ocular symptom for diabetic retinopathy, we initially didn't consider an DAVFs until brain magnetic resonance imaging [MRI] was done. Diffusion-weighted brain MRI revealed acute cerebral infarction and microhemorrhage in the lesion. Transarterial embolization with mixture of glue and lipiodol obliterated the DAVFs completely. Although the DAVFs fed by multi-arteries, the fistulous portion has been disappeared after embolization via an only left occipital artery Endovascular embolization of the fistula led to symptomatic improvement, except ocular discomfort.

• Neonatal Medicine
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• v.25 no.3
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• pp.126-130
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• 2018

Parkes Weber syndrome is a rare congenital vascular anomaly, related to the RAS p21 protein activator 1 (RASA1) gene. It is characterized by capillary cutaneous malformations, bony and soft tissue hyperplasia, and multiple arteriovenous fistulas throughout the affected upper or lower extremity. These arteriovenous fistulas can be associated with life-threatening complications such as bleeding, thrombosis, and high output heart failure. In this report, we present a neonate who had a disproportionately hypertrophied left upper limb with port-wine stain, dystrophy of the left humerus, and hypertrophy of the left clavicle on X-ray, and arteriovenous malformation and massive dilatation of the left subclavian artery on magnetic resonance angiography. Exome sequencing analysis revealed a novel heterozygous splicing mutation (c.1776+2T>A) in the RASA1 gene. To the best of our knowledge, this report is the first case of RASA1-related Parkes Weber syndrome in Korea.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.216-220
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• 2005

Pulmonary arteriovenous fistulas(PAVFs) is a rare disorder that occurs in two to three children per 100,000 population. It is presented as absence of intervening capillary beds between the pulmonary artery and vein with resultant persistent right to left shunt. Other causes include trauma, liver cirrhosis, malignancy and schistosomiasis. It is mostly asymptomatic, but it may present with respiratory difficulty, cyanosis, clubbed fingers induced by right to left shunt or hemoptysis, polycythemia and epistaxis. Major complications, such as brain abscess, brain embolism, paradoxical embolism and subacute infective endocarditis can be devastating, so therapeutic intervention is recommended in all patients. However, removal of low-resistance fistulas can aggrevate pulmonary hypertension, so detection of increased pulmonary pressure is important. We report two patients : One a 42 year-old male with PAVFs treated with coil embolization, and a 42 year-old female who was treated with anticoagulants due to pulmonary hypertension.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.551-555
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• 2001

False aneurysms(Pseudoaneurysms) and arteriovenous fistulas have only rarely been reported in the facial region. In this region the false aneurysm arises most frequently in the superficial temporal and facial artery, but other branches of the external carotid are sometimes involved, including the maxillary and lingual artery. False aneurysms can be occurred by blunt trauma that either laceration or rupture the full thickness of the arterial wall. The diagnosis of a false arterial aneurysm can be often made solely on the basis of physical examination. Angiography is helpful for conformation, for delineating the lesion and its vascular supply, and for ruling out the presence of associated vascular lesions such as arteriovenous fistulas. Ultrasonography may also be useful in delineating lesions that are not easily accessible for physical examination. Treatment of false aneurysms is excision, ligation, and arterial embolization. This is a case of false aneurysm of the lingual artery after facial trauma caused by traffic accident. The lesion was successfully treated by embolization and ligation of the lingual and facial branches of the external carotid artery.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.489-497
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• 2023

Intracranial dural arteriovenous fistula (DAVF) is an abnormal arteriovenous shunt accounting for approximately 10%-15% of all intracranial vascular malformations. Most intracranial DAVFs are solitary, but multiple lesions at different sites can rarely occur. Most intracranial multiple DAVFs are synchronous types, whereas metachronous lesions are relatively uncommon. Herein, we report a rare case of metachronous DAVF occurring after the embolization of a preceding lesion in a 75-year-old female.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.60-64
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• 2009

Nontraumatic intracranial subarachnoid hemorrhage (SAH) attributable to the thoracolumbar dural arteriovenous fistulas (DAVFs) has been extremely rare. A 41-year-old male patient was admitted with severe acute headache, neck stiffness, and pronounced low-back pain radiating to both legs. The T2-weighted MR imaging showed irregular signal void and enlarged, varix like pouch formation with spinal cord compression at the T11-12 level. The angiogram revealed a DAVF. We report a DAVF case with SAH that revealed an extensive infarction from C5 to the conus medullaris after undergoing operative treatment.