• Title/Summary/Keyword: Fistula, arteriovenous

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Coronary Arteriovenous Fistula Draining into the Main Pulmonary Artery (폐동맥으로 유입되는 관상동정맥루수술치험 1례)

  • 김학제
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.143-147
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    • 1988
  • Congenital coronary arteriovenous fistula is a communication of a coronary artery with one of the atria, ventricles, the coronary sinus, the superior vena cava, or the pulmonary artery. We had a successful surgical experience with 63 year-old-female patient who complained substernal chest pain on exertion for 8 years. On auscultation, a continuous murmur was heard at the left second to third intercostal space along the left sternal border. The right cardiac catheterization was revealed to 4% oxygen step up between right ventricle to main pulmonary artery, and Qp/Qs was 1.3:1. The selective coronary arteriography showed markedly tortuous dilated vessel which originated from left coronary artery draining into the main pulmonary artery. The operation performed to mid portion of tortuous and dilated fistula by multiple ligation with 3-0 Mersilene and suture ligation with pledgetted 3-0 Prolene on distal draining site, Postoperative course were uneventful without any symptoms and complications.

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Update on the Vein of Galen Aneurysmal Malformation : Disease Concept and Genetics

  • Hyun-Seung Kang
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.308-314
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    • 2024
  • Vein of Galen aneurysmal malformation is one of important pediatric arteriovenous shunt diseases, especially among neonates and infants. Here, early history of the disease identification, basic pathoanatomy with a focus on the embryonic median prosencephalic vein, classification and differential diagnoses, and recent genetic studies are reviewed.

Effect of the Information Providing Program Provided by Operating Room Nurses on Anxiety and Self-Efficacy of Arteriovenous Fistula and Angioplasty Patients (수술실 간호사의 정보제공프로그램이 동정맥루 및 혈관성형술 환자의 불안과 자기효능감에 미치는 효과)

  • Lee, Hea-Won;Park, Sung-Ju
    • Journal of Digital Convergence
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    • v.18 no.2
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    • pp.447-453
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    • 2020
  • This study used a nonequivalent control group pretest-posttest design to develop an information provision program for arteriovenous fistula and angioplasty patients and to examine the effects of the information provision program offered by operating room nurses. The research subjects were selected trough convenience sampling who had come to hospitals to have an arteriovenous fistula and angioplasty surgery, and an experimental group and a control group of 40 persons. The information provision program consisted of two sessions, each conducted on the day of surgery and after surgery. The content included surgery information, pain management after surgery, management of dialysis blood vessels, how to handle emergency, and management of complications. The results of the study showed that the experimental group, which was offered an information provision program by nurses, a decrease in trait and state anxiety and an increase in self-efficacy on a statistically significant level. In conclusion, the information provision program provided by operating room nurses helped to reduce anxiety in arteriovenous fistula and angioplasty patients and increase their self-efficacy. This will improve end-stage renal disease patients' self-management ability after surgery, and thus, contribute to improving the prevention of complications and the level of self-nursing care.

Long-Term Results of Arteriovenous Fistula for Hemodialysis in Chronic Renal Failure (혈액투석을 위한 동정맥루의 장기관찰 성적)

  • 김인광
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.764-769
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    • 1994
  • From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

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Clinical Analysis of Arteriovenous Fistulas for Hemodialysis (혈액 투석을 위한 동정맥루 조성술의 임상적 고찰)

  • 손영상;조원민;류세민;황재준;조성준;최영호;김학제;허영숙
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.369-374
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    • 2002
  • Background: Proper construction of vascular access and adequate maintenance are essential for the prognosis of the hemodialysis patients. Though arteriovenous fistula using autogenous vessel is the first of choice, the incidence of arteriovenous fistula using artificial graft is gradually increasing. The aim of this study was to analyse the patency rates between autogenous and artificial fistula, among artificial graft types, according to the accompanied disease. Material and Method: A retrospective study was conducted on 186 patients who underwent 292 arteriovenous fistula operations for hemodialysis at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 54.37 $\pm$ 12.79years, and the male: female ratio 99:87. Result: Among 292 operations, there were 156 autogenous fistula and 116 graft fistula. The other 20 operations were thrombectomy, takedown of graft, revision, and balloon dilatation. Patency rates of autogenous fistula were 92.78 $\pm$ 2.35% at 1 year and 39.03$\pm$9.08% at 5 years, and those of graft fistula were 96.09 $\pm$ 2.22% at 1 year and 16.45 $\pm$ 10.15% at 5 scars. However, there was no statistical significance between the two operations. The patients who had hypertension, diabetes or both had no statistical significance in the patency rate compared to that of patients without underlying disease. In addition, the type of graft used did not affect the patency rate. Second operation was needed in 62 patients and third operation in 31 patients, but their patency rate again had no statistical significance compared to that of the first operation. Conclusion: The patency of the artificial graft fistula was comparable to the autogenous fistula, but the patency according to types of graft need to be studied further. Furthermore, the underlying diseases did not affect the fistula patency.

Nursing Care of Arteo Venous Fistula for the Patient Undergoing Hemodialysis

  • Vasuki, R;Kim, Jeongmi
    • International Journal of Internet, Broadcasting and Communication
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    • v.12 no.4
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    • pp.188-195
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    • 2020
  • Purpose: This study aimed to review the recent scientific literature regarding nursing care of arteriovenous fistula (AVF) for the patients with Chronic Renal Failure (CRF) undergoing hemodialysis. Methods: An integrative review was conducted and articles were searched from Cochrane library, Medline, PubMed, Science direct and CINAHL databases by using the terms "nursing", 'Chronic Renal Failure', 'Haemodialysis', renal failure', 'or 'AV Fistula' nursing care', 'self-care'. The inclusion criteria were articles published in English in the year of 2015-2020 with availability of free full text. Reviewed data were carefully analyzed and charted regard to the nursing care of the patient with AVF. Results: 12 articles papers met the inclusion criteria. Three themes were derived from the data: (a) Intervention (b). Patient and nurse education (c) KPA Assessment of (Knowledge, Practice and Attitude) Conclusions: This review indicates the challenges that nursing care of AVF patients undergoing hemodialysis. The identified themes can be used in the development of more effective educational- programs. Future studies should focus on the development and evaluation of educational programs that include these selected themes.

Comparison of Single- and Multi-Echo Susceptibility-Weighted Imaging in Detecting Cerebral Arteriovenous Shunts: A Preliminary Study (뇌동정맥단락 진단에서의 단일 에코 자화율 강조영상과 다중 에코 자화율 강조영상의 비교: 예비 연구)

  • Seung Wan Han;Jae Ho Shin;Yon Kwon Ihn;Seung Ho Yang;Jae Hoon Sung
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.226-239
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    • 2023
  • Purpose To compare the sensitivities of T2-weighted image (T2WI) and susceptibility-weighted imaging (SWI) in detecting cerebral arteriovenous fistula (AVF), cerebral arteriovenous malformation (AVM), and carotid-cavernous sinus fistula (CCF), and to qualitatively evaluate single-echo SWI (s-SWI) and multi-echo SWI (m-SWI) in characterizing vascular lesions. Materials and Methods From January 2016 to December 2021, cerebral angiography-proven lesions were recruited. The sensitivities of T2WI and SWI in detecting vascular lesions were compared using McNemar's test. Qualitative evaluations of s-SWI and m-SWI were categorized to be of poor, average, or good quality and compared using Fisher's exact test. Results A total of 24 patients (mean age: 61 years, 12 female, and 12 male) were enrolled. Twenty patients underwent s-SWI or m-SWI, and four patients underwent both. AVF, AVM, and CCF were diagnosed in 10, 11, and 3 patients, respectively. SWI demonstrated higher sensitivity compared to that of T2WI (82.1% vs. 53.6%, p = 0.013). m-SWI showed better image quality compared to that of s-SWI (good quality, 83.3% vs. 25.0%, p = 0.009). Conclusion SWI demonstrated a higher sensitivity for detecting cerebral arteriovenous shunts compared to that of T2WI. m-SWI exhibited better image quality compared to that of s-SWI in characterizing vascular lesions.

Spinal Dural Arteriovenous Fistulas : Clinical Experience with Endovascular Treatment as a Primary Therapeutic Modality

  • Park, Sung-Bae;Han, Moon-Hee;Jahng, Tae-Ahn;Kwon, Bae-Ju;Chung, Chun-Kee
    • Journal of Korean Neurosurgical Society
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    • v.44 no.6
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    • pp.364-369
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    • 2008
  • Objective : The aim of this study was to evaluate the efficacy of endovascular therapy as a primary treatment for spinal dural arteriovenous fistula (DAVF). Methods : The authors reviewed 18 patients with spinal DAVFs for whom endovascular therapy was considered as an initial treatment at a single institute between 1993 and 2006. NBCA embolization was considered the primary treatment of choice, with surgery reserved for patients in whom endovascular treatment failed. Results : Surgery was performed as the primary treatment in one patient because the anterior spinal artery originated from the same arterial pedicle as the artery feeding the fistula. Embolization was used as the primary treatment modality in 17 patients. with an initial success rate of 82.4%. Two patients with incomplete embolization had to undergo surgery. One patient underwent multiple embolizations, which failed to completely occlude the fistula but relieved the patient's symptoms. Spinal DAVF recurred in two patients (one collateral development and one recanalization) during the follow-up period. The collateral development was obliterated by repeated embolization, but the patient with recanalization refused further treatment. The overall clinical status improved in 15 patients (83.3%) during the follow-up period. Conclusion : Endovascular therapy can be successfully used as a primary treatment for the majority of patients with spinal DAVFs. Although it is difficult to perform in some patients, endovascular embolization should be the primary treatment of choice for spinal DAVF.

Arteriovenous Fistula between Renal Artery and Inferior Vena Cava following Penetrating Abdominal Trauma; A Case Report (자상 후 발생한 신동맥과 하대정맥간 정맥루)

  • Kim, Joong Suck;Go, Seung Je;Kim, Ji Dae;Sul, Young Hoon;Ye, Jin Bong;Park, Sang Soon;Ku, Gwan Woo;Kim, Yeong Cheol
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.262-265
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    • 2015
  • An arteriovenous fistula (AVF) from the renal artery following a penetrating abdominal trauma is not common. We report the case of a 19-year-old male who presented with a knife stab wound in the right upper quadrant. Due to unstable vital signs and to the protrusion of the mesentery through the stab wound, providing definite evidence of peritoneal violation, an emergent exploratory laparotomy was carried out. There were injuries at the proximal transverse mesocolon and the second portion of the duodenum, with bile leakage. There was also a mild amount of retroperitoneal hematoma near the right kidney, without signs of expansion or pulsation. The mesocolon and the duodenum were repaired. After the operation, abdominal computerized tomography (CT) was performed, which revealed contrast from the right renal artery shunting directly into the vena cava. Transcatheter arterial embolization with a coil and vascular plug was performed, and the fistula was repaired. The patient recovered completely and was discharged without complication. For further and thorough evaluation of an abdominal trauma, especially one involving the retroperitoneum, a CT scan is recommended, when possible, either prior to surgery or after surgery when the patient is stabile. Furthermore, a lateral retroperitoneal hematoma and an AVF after a penetrating trauma may not always require exploration. Sometimes, it may be safely treated non-operatively or with embolization.

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Intracranial Pial Arteriovenous Fistulas

  • Lee, Ji-Yeoun;Son, Young-Je;Kim, Jeong-Eun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.101-104
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    • 2008
  • Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion that has only recently been recognized as a distinct pathological entity. A 41-year-old woman (Patient 1) presented with the sudden development of an altered mental state. Brain CT showed an acute subdural hematoma. A red sylvian vein was found intraoperatively. A pial AVF was revealed on postoperative angiography, and surgical disconnection of the AVF was performed. A 10-year-old boy (Patient 2) presented with a 10-day history of paraparesis and urinary incontinence. Brain, spinal MRI and angiography revealed an intracranial pial AVF and a spinal perimedullary AVF. Endovascular embolization was performed for both lesions. The AVFs were completely obliterated in both patients. On follow-up, patient 1 reported having no difficulty in performing activities of daily living. Patient 2 is currently able to walk without assistance and voids into a diaper. Intracranial pial AVF is a rare disease entity that can be treated with surgical disconnection or endovascular embolization. It is important for the appropriate treatment strategy to be selected on the basis of patient-specific and lesion-specific factors in order to achieve good outcomes.