1/101. Clinical findings in a patient with spontaneous arteriovenous fistulas of the orbit.PURPOSE: To report clinical and radiologic findings of a patient with spontaneous arteriovenous fistulas of the orbit. METHOD: Case report. RESULTS: A 73-year-old woman was initially examined with a 1-year history of mild proptosis of the right eye. She had no history of trauma. Neuro-ophthalmologic examination disclosed dilatation of conjunctival vessels, increased intraocular pressure, mild proptosis and bruit in the right eye, and ocular signs suggestive of carotid-cavernous sinus fistulas or orbital arteriovenous malformations. The patient exhibited dilation of the superior ophthalmic vein in enhanced computed tomography of the orbit. Selective cerebral angiography disclosed communications between branches of both ophthalmic and facial arteries and the superior ophthalmic vein in the orbit. CONCLUSION: Arteriovenous fistulas of the orbit must be considered in the differential diagnosis of carotid-cavernous sinus fistulas and arteriovenous malformations, although they are quite rare.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/101. A case of diffuse pulmonary arteriovenous fistula.A 30-year-old Japanese woman was admitted to hospital for dyspnea. She had a history of corrective surgery for a large atrial septal defect and partial anomalous pulmonary venous drainage, which had produced cyanosis in her infancy. However, her cyanosis continued postoperatively. Angiography revealed a double inferior vena cava (IVC), with the left IVC connected with the hemiazygos vein and the right IVC with the left atrium through a very small orifice. Most of the blood from the 2 IVCs flowed into the superior vena cava via the distended azygos and hemiazygos veins. Pulmonary arteriography revealed no abnormal structures. Pulmonary arterial pressure was normal. There was marked pulmonary venous oxygen desaturation. perfusion lung scintigraphy revealed multiple segmental perfusion defects. These findings suggested the presence of diffuse microscopic pulmonary arteriovenous fistulas bilaterally in the lungs. The patient appears to be the first reported adult case of microscopic and diffuse arteriovenous fistulas. Neither resection of the arteriovenous fistulas nor corrective surgery for the diversion was indicated, and heart-lung transplantation might be the only treatment able to relieve her dyspnea.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/101. Deterioration of ocular motor dysfunction after transvenous embolization of dural arteriovenous fistula involving the cavernous sinus.We treated 9 patients with the dural arteriovenous fistula involving the cavernous sinus by transvenous embolization. Two patients experienced deterioration of oculo-motor dysfunction after transvenous embolization. We can speculate about two different kind of causes by which patients symptoms deteriorated according to the result of intrasinus pressure recorded during the embolization [1]: high intrasinus pressure caused by the obliteration of the drainage pathway resulted in cranial nerve palsy in one case [2]; implanted coils directly compressed the cranial nerve in another case. Fortunately our cases recovered, but some kind of preventative measures may be needed in similar cases.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
4/101. Endovascular treatment of arteriovenous fistulas complicating percutaneous renal biopsy in three paediatric cases.DESIGN: We evaluated the incidence and history of arteriovenous fistula (AVF) after kidney biopsy and assessed the use of superselective embolization for treatment. OBSERVATIONS: During the last 10 years, 896 kidney biopsies (age range of the patients: 1 month-18.6 years) have been performed in our institution under real-time ultrasonographic guidance with a 14 gauge cutting biopsy needle, and 32 of the patients had renal allografts (3.4%). We observed three cases of AVF (two in allograft kidneys, one in a native kidney) among all biopsies (0.34%), and the incidence of developing AVF after renal allograft biopsy was 6.3%. All three patients with AVF were symptomatic, and intravascular therapy was indicated. INTERVENTIONS: An angiographic study combined with endovascular treatment of the intrarenal AVF and pseudoaneurysm was performed in all three patients. Embolization was performed with bucrylate and lipiodol in two patients and with micro-coils in one. After successful embolization, all three patients became asymptomatic (in two renal bleeding stopped, in one patient with severe uncontrollable hypertension blood pressure returned to normal limits). No complications were observed secondary to the embolization procedure. CONCLUSION: The technique of superselective embolization using a coaxial catheter is an effective and safe method in the treatment of post-biopsy AVFs and pseudoaneurysm.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/101. Carotid artery-sygmoid sinus fistula: a rare complication of gunshot wound on the base of the cranium.Vascular lesions without clinical manifestation may occur in cranial-facial wounds produced by bullets that course the base of the cranium. This work describes a rare kind of vascular complication in cranial-facial gunshot wound. The authors present the case of a patient, the victim of a cranium-maxillary gunshot wound. Carotid angiography revealed a carotid-sygmoid sinus fistula that filled the sygmoid and transverse sinuses, concomitant to the arterial angiographic phase. A direct communication between the external carotid artery and the sygmoid sinus was disclosed. We are not aware of any other description of this vascular complication in cranial gunshot wound. It is important to recognize this kind of complication in cases of cranial-facial gunshot wound, because new factors harmful to the brain perfusion systems are introduced, in addition to the alterations to venous return and intracranial pressure, caused by the primary trauma. The new non-invasive vascular diagnostic methods are proving useful in filling the gap left by arteriography, which is no longer used in these cases.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/101. Unilateral exophthalmos caused by traumatic vertebral artery to vertebral and jugular vein fistula: problems in diagnosis and management.skull base venous fistulas are rare. A 15-year-old boy was stabbed in the left side of his neck, just below the mastoid process. Two years later, he presented with a protruded and pulsating left eye with red sclera. A soft murmur was audible all over his head and neck. Angiography revealed an arteriovenous fistula between the third portion of the vertebral artery (V3) and the vertebral venous plexus, as well as the ipsilateral jugular vein (VVJF). The fistula recruited several arterial feeders and rising the venous pressure along the outflow system of the skull base had led to unilateral exophthalmos.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/101. Prerenal hypertension caused by a postoperative A-V fistula.The A-V fistula in the renal pedicle with functioning renal parenchyma leads to a prerenal hypertension by the blood-steal effect from the renal artery through the fistula into the vein, according the pressure gradient over the fistula. The etiology of these A-V fistulas is pointed out. A case corrected by surgical removal of the fistula is reported.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/101. Spontaneous vertebral arteriovenous fistula--case report.A 57-year-old male presented with a rare case of spontaneous vertebral arteriovenous fistula manifesting as radiculopathy of the right arm, subsequently associated with pulsating tinnitus and vascular bruit in the nape. He had a past history of chiropractic-induced vertebrobasilar infarction. Angiography showed a simple and direct fistula between the third segment of the right vertebral artery and the epidural veins at the C-1 level, where the artery runs backward above the arch of the C-1 just proximal to the penetration of the dura. The fistula was successfully obliterated by coil embolization, resulting in rapid improvement of the signs and symptoms. Mechanical compression to the nerve roots by the engorged epidural veins with arterial pressure was considered to be the major cause of radiculopathy. vertebral artery dissection induced by chiropractic manipulation is most likely responsible for the development of the fistula.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/101. Multiple intrapulmonary arteriovenous fistulas in childhood.Pulmonary arteriovenous fistulas (AVFs) are a rare but recognized cause of cyanosis in childhood. Lesions may be acquired as in hepatopulmonary syndrome or they may be congenital, particularly in association with certain multisystem disorders. Large fistulas are more common than multiple small connections. Two cases. both boys, presenting in the first decade of life are described. "Bubble" echocardiography was the most telling investigation and strongly suggested the presence of AVFs in both cases. Each patient then underwent cardiac catheterization, which demonstrated normal pulmonary artery pressure and diffuse pulmonary telangiectasis. Both patients were treated effectively with nifedipine and continue with this mode of therapy.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/101. Sinoatrial nodal artery aneurysm with right ventricular outflow tract compression: report of a case.We described a 16-year-old boy with sinoatrial nodal (SAN) artery aneurysm that drained into right atrium and compressed right ventricular outflow tract. The patient was clinically asymptomatic. Hemodynamic study revealed a 15 mm Hg peak systolic pressure gradient at right ventricular outflow tract. The fistula was successfully excised without sequalae. Cathet. Cardiovasc. Intervent. 51:328-331, 2000.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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