• Journal of Medicine and Life Science
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• v.20 no.3
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• pp.115-125
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• 2023

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

• Journal of Korean Biological Nursing Science
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• v.14 no.4
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• pp.300-307
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• 2012

Purpose: The purpose of this research was to develop and prove the effectiveness of structured arm exercise, which was used to reduce Arteriovenous Fistula (AVF) and Arteriovenous graft (AVG) stricture of hemodialysis patients. Methods: Quasi-experimental research design with non-equivalent control group was applied. 26 Subjects were participated in this study. 12 of hemodialysis patients who do not have a normal range of Static Intra Access Pressure Vein (SIAPV) score in the last three months were assigned to the experimental group and 14 patients who have a normal range of SIAPV score in the last three months to the control group. To analyze the collecting data after structured arm exercise, non parametric method with the repeated measures ANOVA by the Friedman test and Wilcoxon Signed Ranks Test for post-hoc test was performed. Results: Unlike the experimental group after three months, the control group's SIAPV data went over the normal range. The experimental AVF group showed a difference in data after month 2 and month 3. - In AVG group, there were clear differences in each month of the test. Conclusion: This study proved that structured arm exercise therapy could be a simple and effective intervention. It is suggested to be actively utilized for hemodialysis patients.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1472-1477
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• 2020

Dural arteriovenous fistula is an acquired vascular anomaly that can cause various symptoms. Here, we report a rare case of Borden type I sigmoid sinus dural arteriovenous fistula presenting as subarachnoid hemorrhage. Bleeding occurred from a side-wall aneurysm in the lateral pontomedullary segment of the anterior inferior cerebellar artery, which was a minor pial feeder. Features on imaging modalities, including brain CT, CT angiography, MR imaging/angiography and digital subtraction angiography, are described with a literature review.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.407-410
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• 2006

Carotid artery-internal jugular vein arteriovenous fistula is very rare, but it should be suspected in case of vascular injury by neck trauma because the diagnosis may be missed due to anatomical complexity of neck, We report a 57-year old male who had the carotid artery-jugular vein arteriovenous fistula caused by gunshot injury in the neck 44 years ago.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.702-706
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• 2004

Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4${\times}$4${\times}$3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.362-367
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• 1983

Pulmonary arteriovenous fistula is a congenital malformation resulting from errant capillary development, with incomplete formation or disintegration of the vascular septa that normally divide the primitive connections between the venous and arterial plexuses. It generally occurs as part of the disorder known as hereditary hemorrhagic telangiectasia [Rendu-Osler-Weber disease]. The hereditary lesion is transmitted as a simple non-sex-linked dominant trait. It may be single or multiple, too small to see on plain chest films or large and easily recognized. One third of the lesions are multiple on plain chest film. The pathogenesis of its symptoms is that unoxygenated, desaturated arterial blood enters into the pulmonary venous system, directly. Recently we have experienced a case of the pulmonary arteriovenous fistula in 26 years old male soldier, which was confirmed by pulmonary angiography preoperatively. 2 thumb-tip sized, well circumscribed cystic masses filled with bright red colored blood were seen in subpleural and anterolateral portion of the right upper lobe. Right upper Iobectomy was performed due to close approximation of the fistula with pulmonary vein. Microscopically, it shows angiomatous dilatation of the abnormal vessels embedding in the parenchyma. Postoperative physiologic studies show nearly normal arterial oxygen saturation, hemoglobin and RBC count. There was good, uneventful postoperative course.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.342-348
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• 2004

It is very important for hemodialysis in patients with end stage renal disease to obtain vascular access that resists repeated punctures and maintains adequate blood flow. This study was designed to indentify factors that may influence early patency rate of autogenous arteriovenous fistula. Material and Method: 49 cases in 47 patients who underwent radiocephalic fistula formation in our hospital from June 2002 through May 2003 were reviewed and analyzed. Result: The early patency rate was 79.6%. Age, sex, hypertension, and diabetes mellitus were not significant factors for patency. Body mass index and duration of hypertension and diabetes did not influence the early results either. Cephalic vein diameter measured preoperatively and blood flow at radio-cephalic fistula were significantly positive correlative factors. Groups with the vein diameter less than 2.7mm, or with the blood flow less than 100 mL/min had significantly lower early patency rate than the other groups. Conclusion: To improve early patency rate of radiocephalic fistula, large sized cephalic vein should be selected and if the intraoperative flow at radiocephalic fistula is less than 100 mL/min, another arteriovenous fistula formation should be considered.

• Journal of Chest Surgery
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• v.24 no.12
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• pp.1167-1172
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• 1991

Since March 1988 we have performed 133 arteriovenous fistulae for hemodialysis in 121 patients with chronic renal failure. Of the 133 cases of arteriovenous fistulae, follow-up evaluation was possible for 80 cases which performed in 69 patients. The relation between blood flow and patency rate and duration of arteriovenous fistula was examined. The overall 6 - 12 - 18 -, and 24 - month patency rates of arteriovenous fistulae were 82%, 64%a, 62%, and 57%, respectively. The maximum blood flow was 150 ~ 350ml /min[mean 217.1$\pm$44.27]. The patency duration was evaluated in patients divided into three groups owing to maximum blood flow through the fistulae. The range of maximum blood flow was 150 ~ 200ml /min for group A, 200 ~ 250ml /min for group B, and above 250ml /min for group C. The mean duration of the patency was 10.7$\pm$7.60 months in group A, 14.9$\pm$9.82 months in group B, and 21.6$\pm$11.16 months in group C[p<0 05]. With increased maximum blood flow, the duration of the patency was longer in group A than group B and C [r=0.39, p<0. 05]. The maintenance blood flow was 100 ~ 250ml /min[mean 179.2$\pm$37.26 ml/min]. When the maintenance blood flow was above 200ml /min, long-term patency rate was higher than the group below 200ml /min[r=0.48, p<0.01]. In the same range of blood flow, patency duration of the patients with using their own blood vessels were longer than the patients with using vascular graft for A-V fistula. We concluded that the patency of the arteriovenous fistulae was closely correlated with the blood flow through the fistulae.

• 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 Biomedical Engineering Research
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• v.24 no.4
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• pp.329-337
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• 2003

Blood in congenital or acquired AY fistula(arteriovenous fistula) flows from arteries directly to veins. detouring peripheral micro-circulation. This makes a great effect on the hemodynamics of human cardiovascular system. In this study, a computational method using lumped parameter mode) was proposed to simulate the cardiovascular hemodynamics of patients with acute AV fistula The cardiovascular system model with a fistula compartment in left lower limb was built using 17 standard lumped compartments. Using fourth order Runge-Kutta method. we solved numerically the unsteady linear set of the ordinary differential equations resulting from application of Kirchhoff's law to the lumped parameter hemodynamic model. The baroreceptor reflex system was implemented to explain the auto-regulation effect of the cardiovascular system with acute AV fistula.