• 제목/요약/키워드: Fistula, arteriovenous

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Development of a Pulmonary Arteriovenous Fistula after a Modified Glenn Shunt in Tetralogy of Fallot and Its Resolution after Shunt Takedown in a 57-Year-Old Patient

  • Kim, Sang Yoon;Kim, Eung Rae;Bang, Ji Hyun;Kim, Woong-Han
    • Journal of Chest Surgery
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    • 제50권3호
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    • pp.215-219
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    • 2017
  • Pulmonary arteriovenous fistula (PAVF) is a complication of the Glenn shunt. A 57-year-old tetralogy of Fallot (TOF) patient, who had undergone a Glenn shunt and TOF total correction, complained of dyspnea and cyanosis. PAVFs were present in the rig ht lung, and rig ht lung perfusion was nearly absent. After coil embolization, takedown of the Glenn shunt, and reconstruction of the rig ht pulmonary artery, the patient's symptoms were relieved. Extrapulmonary radioisotope uptake caused by the PAVFs shown in lung perfusion scans decreased, and right lung perfusion increased gradually. Although the development and resolution of PAVFs after a Glenn shunt have been reported in the pediatric population, this may be the first report on this change in old age.

혈액투석 환자의 동정맥루 천자 방향과 천자 간격이 재순환율에 미치는 영향 (The effect of Arteriovenous Fistula Cannulation Direction and Puncture Distance on the Recirculation Rate of Hemodialysis Patients)

  • 임효정;최은희;김은주;정지윤;반승수
    • 중환자간호학회지
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    • 제11권1호
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    • pp.28-34
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    • 2018
  • Purpose : The purpose of this study was to compare the effect of recirculation rate according to cannulation direction and interval among hemodialysis patients with arteriovenous fistula (AVF). Method : The research used repeated measures design. This study was conducted among thirty patients who received hemodialysis three times a week for longer than a year through AVF at the I University hospital. Three different types of interventions were administered to the participants each week for three weeks. Needles were placed at a different distance and in a different direction each week: 7 cm apart from each other in antegrade direction during the first week, 5 cm apart in retrograde direction in the following week, and 7 cm apart in retrograde direction in the third week. Results : No significant differences in the recirculation rate were found due to any of the three tested methods (p = 1.00). Conclusion : This finding suggests that, if the patients have well-functioned AVF, we can choose an appropriate intervention from among the three methods in consideration of the patient's diverse needs.

척수경막동정맥루로 인한 척수병증 환자의 색전술 이후 한의복합치료: 증례 보고 (Complex Korean Medical Treatment after Embolization for Myelopathy Due to Spinal Dural Arteriovenous Fistula: A Case Report)

  • 우현준;한윤희;이정한
    • 한방재활의학과학회지
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    • 제31권3호
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    • pp.105-114
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    • 2021
  • A 38-year-old Korean man without any other history was diagnosed with myelopathy due to a spinal dural arteriovenous fistula. Following embolization and high-dose steroid therapy, the patient was treated with complex Korean medical therapies including acupuncture, pharmacopuncture, electro-acupuncture, Chuna manual therapy, herbal medicine, and cupping therapy in addition to conventional treatment. To assess the patient's improvement, international standard for neurological classification of spinal cord injury, Korean version of modified Barthel index, functional independence measure, spinal cord independence measure III, walking index for spinal cord injury II, modified Ashworth scale were used. After treatment, the muscle strength and sensory function of the lower extremities were improved, and the spasticity was reduced, resulting in a rapid improvement in performance of daily activities. These results suggest that complex Korean medical therapies may be effective for myelopathy, and further clinical studies are needed to clarify their effects.

혈액투석 환자의 동정맥루 천자 시 피부자극법과 국소마취크림 도포에 따른 통증과 심박변이도 비교 (Comparison of Skin Stimulation Method and Topical Anesthetic Cream on Pain and Heart Rate Variability during Arteriovenous Fistula Puncture in Hemodialysis Patients)

  • 강효영;채영란
    • Journal of Korean Biological Nursing Science
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    • 제21권3호
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    • pp.207-216
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    • 2019
  • Purpose: The purpose of this was to compare effects of application of the skin stimulation method and topical anesthetic cream on pain, heart rate variability and satisfaction according to nursing intervention methods during arteriovenous fistula puncture in chronic renal failure hemodialysis patients. Methods: This study was a crossover design. Participants were 36 patients with chronic renal failure receiving hemodialysis treatment. Two forms of intervention were applied to participants, and then pain and heart rate variability were measured during the puncture. Results: There were no statistically significant differences according to each treatment in vein pain and artery pain. Also, there were no statistically significant differences according to each treatment in stress index, sympathetic activity (LF), parasympathetic activity (HF) and sympathetic activity/parasympathetic activity (LF/HF ratio). Satisfaction with application of skin stimulation method was statistically higher than that of topical anesthetic cream application. Conclusion: This suggests that application of the skin stimulation method complements disadvantages of topical anesthetic cream application and demonstrates possibility of application as a nursing intervention method which can be conveniently used by nurses in clinical practice.

Delayed Cerebral Ischemia after Embolization in Ruptured Spinal Arteriovenous Fistula with Subarachnoid Hemorrhage : A Case Report

  • Achmad Firdaus Sani;Dedy Kurniawan;Muhammad Hamdan;Jovian Philip Swatan
    • Journal of Korean Neurosurgical Society
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    • 제66권2호
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    • pp.205-210
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    • 2023
  • Delayed cerebral ischemia (DCI) remains a devastating complication in subarachnoid hemorrhage (SAH), however, there were no present reports that is associated with a ruptured spinal arteriovenous fistula (sAVF). We would like to present a rare case of DCI following embolization of a ruptured perimedullary sAVF. Initially, the patient clinical symptoms mimic a SAH caused by a ruptured intracranial aneurysm. Further evaluation revealed that the SAH was caused by a ruptured perimedullary sAVF and the patient's condition improved following the embolization procedure. Three days later, the patient developed an acute left-sided facial and motor weakness, which persisted until the patient was discharged on the day-15 onset. A magnetic resonance imaging and angiography is performed 1.5 years after discharge and revealed no signs of cerebral infarction and hemorrhage. In this paper, we reported DCI after embolization in a ruptured sAVF with SAH, supported by evidence from the current literature. We would like to also stress the importance of complete spinal and cerebral vessel imaging to reveal the underlying abnormalities and determine the most appropriate intervention.

동측의 동정맥루를 가진 만성 신부전증 환자의 회전근개 파열에 대한 관절경적 수술 이후 발생한 혈관절증 (Hemarthrosis Occurred after Arthroscopic Rotator Cuff Repair in a Chronic Renal Failure Patient with a Stenosis in an Ipsilateral Arteriovenous Fistula)

  • 허순호;김세진;박진영;강경록
    • 대한정형외과학회지
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    • 제54권4호
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    • pp.366-371
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    • 2019
  • 견관절의 병변에 대해 관절경적 수술을 시행한 후 발생한 혈관절증은 매우 드문 합병증으로 전방 삽입구의 형성 도중 혈관의 손상으로 인해 발생할 수 있으며 항혈전제를 복용중이거나 혈소판 감소증 등 동반질환이 없을 경우 발생하기 어려운 합병증이다. 저자들은 동측 상완부에 혈액투석을 위한 동정맥루의 협착이 있는 환자에게 회전근개 파열에 대한 관절경적 수술을 시행한 후 발생한 혈관절증의 사례를 보고하는 바이다.

Arteriovenous Fistula Formation Using Microscope Rather than Surgical Telescope

  • Lee, Byeong Ho;Suh, In Suck;Cho, A Jin;Noh, Jung Woo;Jeong, Hii Sun
    • Archives of Reconstructive Microsurgery
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    • 제23권2호
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    • pp.97-100
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    • 2014
  • The number of patients with chronic renal failure who require renal replacement therapy is increasing and dialysis is still the mainly used renal replacement therapy. The first choice of surgical technique currently used is side-to-end anastomosis of the radial artery and the cephalic vein. The authors report on a case of an effective arteriovenous shunt operation performed using microscopy. A 53-year-old male with chronic renal failure was referred to plastic and reconstructive surgery department to undergo an arteriovenous shunt operation. Venography was performed before surgery in order to find the appropriate vessel for the arteriovenous shunt operation. The cephalic vein on the wrist showed a diameter of over 4 mm, which was appropriate for an arteriovenous shunt operation. Anastomosis of the vessels was performed under microscopy using Nylon #9-0. Blood flow and vessel diameter were evaluated by venography after surgery and showed well maintained function of the shunt. Complications such as bleeding, edema of the upper arm, and wound dehiscence did not occur. Many factors and certain complications may affect the long-term patency of an arteriovenous shunt; however, exquisite surgical technique is the most important factor in a successful operation. Thus, arteriovenous shunt operation using microscopy is thought to be a good treatment option.

리도카인 연고도포가 혈액투석 환자의 동·정맥루 천자 통증과 불안에 미치는 효과 (The Effect of Topical Application of Lidocaine Cream before Arteriovenous(AV) Fistula Puncture on Pain and Anxiety Among Hemodialysis Patients)

  • 현경선;이성연;한상순
    • 성인간호학회지
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    • 제20권3호
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    • pp.386-394
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    • 2008
  • Purpose: The purpose of this study was to examine the effect of topical lidocaine cream on pain and anxiety during the AV fistula puncture among hemodialysis patients. Methods: The study employed one group repeated measurement design. The data were collected from 50 hemodialysis patients who received AV fistula puncture. The topical lidocaine cream was applied 30 minutes before the puncture. The data were measured total 3 times (T1=without lidocaine, T2=2% lidocaine, T3=5% lidocaine). Pain was measured by VAS and a behavioral checklist. Anxiety was measured by Korean manual of SCL-90-R. Results: Patients with 5% lidocaine cream reported significantly lower of VAS pain score than those with 2% lidocaine and without lidocaine. Patients with 2% lidocaine cream reported significantly lower of behavioral pain scores than those without lidocaine, but less effective than 5% lidocaine cream. Patients with 2% lidocaine cream reported significantly lower of anxiety scores than those without lidocaine, but less effective than 5% lidocaine cream. Conclusion: Topical application of lidocaine cream for 30 minutes before AV fistula puncture significantly decreased pain and anxiety among hemodialysis patients. Specifically 5% lidocaine was more effective than 2% lidocaine for both pain and anxiety.

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Transvenous proximal closure of large congenital coronary arteriovenous fistula using the single Amplatzer vascular plug in a 3-year-old girl

  • Jang, Hae In;Choi, Young Earl;Cho, Hwa Jin;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • 제56권2호
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    • pp.90-93
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    • 2013
  • Congenital coronary arteriovenous fistulas (CCAFs) are rare coronary artery abnormalities in which blood is shunted into a cardiac chamber or great vessel. If the fistula itself is large and tortuous, it is generally recommended to occlude the fistula to prevent several complications. In approaches of transcatheter occlusion, the transvenous approach is preferred over the transarterial approach. The transvenous approach would enable the cannulation of a relatively larger catheter or sheath without potential damage to the femoral vessels or normal coronary arteries, which can occur in the transarterial approach. The transvenous approach may also minimize the blind pouch after releasing the devices. Herein, we report the success of transvenous proximal closure of a CCAF using an Amplatzer vascular plug (AVP) in a 3-year-old patient with cardiomegaly. Complete occlusion was achieved by a single AVP and thrombus formation of the distal aneurysmal portion of the fistula. We suggest that this strategy of closing the proximal end with a dilated fistula using a single AVP by the transvenous approach may be a good option in treating CCAFs in a young child.

단관상동맥에 발생한 관상동정맥루 -치험1례- (Single Coronary Artery with Coronary Arterioveous Fistula)

  • 안병희;이동준
    • Journal of Chest Surgery
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    • 제15권3호
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    • pp.366-369
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    • 1982
  • Single coronary artery is rare congenital anomaly with incidence about 0.04%. Above half of single coronary artery is symptomless, and about 41% of cases are associated with another congenital cardiac anomalies . Single coronary artery is sometimes important for cardiac operation to avoid fatal result from cutting of coronary artery during the right ventriculotomy. Among the associated anomaly of the single coronary artery, coronary arteriovenous fistula is very rare. We experienced congenital single coronary artery with coronary arteriovenous fistula drained into the right ventricle, and so we report this case with literatures.

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