201
|
|
202
|
Suzuki K, Kusuda Y, Yamada Y, Nose R, Matsui T, Sanda Y, Mori T, Sugimoto K. [Pelvic arteriovenous malformation : a case report]. Hinyokika Kiyo 2013; 59:439-442. [PMID: 23945325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 70-year-old male presented with intermittent macroscopic hematuria. There was no history of previous trauma or pelvic operation. At first, we were unable to clarify the origin of the hematuria, but 3D computed tomography revealed an arteriovenous malformation (AVM) consisting of multiple feeding vessels arising from the bilateral, especially right, internal iliac artery. Treatment with transcatheter arterial embolization (TAE) with a combination of lipiodol and N-butyl-2-cyanoacrylate twice was effective. He needs to be followed up carefully for recurrence of AVM.
Collapse
Affiliation(s)
- Kotaro Suzuki
- The Department of Urology, Hyogo Pref Hospital, Japan
| | | | | | | | | | | | | | | |
Collapse
|
203
|
Capmas P, Levaillant JM, Teig B, Fernandez H. Uterine arteriovenous malformation involving the whole myometrium. Ultrasound Obstet Gynecol 2013; 41:715-717. [PMID: 23404809 DOI: 10.1002/uog.12432] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 01/21/2013] [Accepted: 02/01/2013] [Indexed: 06/01/2023]
Affiliation(s)
- P Capmas
- Service de Gynécologie Obstétrique, Hôpital Bicêtre, GHU Paris Sud, APHP, Le Kremlin Bicêtre, France.
| | | | | | | |
Collapse
|
204
|
Sopeña B, Pérez-Rodríguez MT, Portela D, Rivera A, Freire M, Martínez-Vázquez C. High prevalence of pulmonary hypertension in patients with hereditary hemorrhagic telangiectasia. Eur J Intern Med 2013; 24:e30-4. [PMID: 23246127 DOI: 10.1016/j.ejim.2012.11.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 10/28/2012] [Accepted: 11/17/2012] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Hereditary hemorrhagic telangiectasia (HHT) is a vascular disorder causing mucocutaneous telangiectases and visceral arteriovenous malformations (AVMs). Pulmonary hypertension (PH) is considered an uncommon complication of HHT whose impact on the survival of these patients is currently unknown. METHODS From January 1995 to December 2008, 29 hospitalized patients with definite HHT were included and followed until January 2011. Data on demographics, clinical symptoms and survival were recorded. PH was classified according to echocardiographic probability. RESULTS A CT angiogram was performed in 24 of the 29 patients with HHT and AVMs were detected in 16 of them (67%): hepatic in 58%, pulmonary in 33% and spinal in 3%; 37% had both pulmonary and hepatic AVMs. Transthoracic Doppler echocardiography (TTE) was performed in 21 patients. PH was considered possible in 4 (14%) and probable in 9 (31%). The mean age at diagnosis was lower in patients with PH than in patients without PH (54±16.5 years vs 73±8.8 years, p=0.002). PH was more prevalent in patients with AVMs (56 vs. 23%, p=0.036). The mean follow-up of the entire cohort was 6±4.4 years (range: 2 months-17 years), during this time 18 patients died (62%; mean age 73±8.1 years). Patients with PH died at a younger age (68±8.4 vs. 79±2.7 years, p=0.015) than those without PH. CONCLUSIONS PH is a severe condition that significantly reduces survival on HHT patients. PH should be suspected in all HHT patients with dyspnea and hepatic AVMs.
Collapse
Affiliation(s)
- Bernardo Sopeña
- Internal Medicine Department, Thrombosis and Vasculitis Unit, Complexo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain.
| | | | | | | | | | | |
Collapse
|
205
|
Ogawa F, Miyaji K, Ishii M, Iyoda A, Satoh Y. Surgical removal of pulmonary arteriovenous malformations subsequent to total cavopulmonary connection conversion long after a Björk procedure. Pediatr Cardiol 2013; 34:739-42. [PMID: 22580771 DOI: 10.1007/s00246-012-0336-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 04/24/2012] [Indexed: 11/26/2022]
Abstract
Because the cavopulmonary shunt procedure is widely used for palliation of complex congenital heart diseases, pulmonary arteriovenous malformations (PAVMs) are relatively well-known complications. The reported patient was a 23-year-old woman who experienced PAVMs in the right lower lobe after a classical Glenn anastomosis and Björk procedure for tricuspid atresia. Her arterial oxygen saturation (SaO2) 14 years after the Björk procedure was ~80 %. She then underwent a total cavopulmonary connection (TCPC) conversion to reduce her PAVMs in the right lower lobe using the "hepatic factor." However, her situation remained unchanged, and she experienced severe systemic cyanosis (SaO2, 70 %) and dyspnea during physical exertion without hemoptysis due to increased blood flow to the PAVMs. Although interventional embolization was considered, it was impossible due to considerable dilation of the main PAVM. Thus, right lower lung lobectomy was performed. After surgery, the patient's SaO2 increased to 90 %. To the authors' knowledge, this is the first case report of a lung resection for residual PAVMs after TCPC conversion.
Collapse
Affiliation(s)
- Fumihiro Ogawa
- Department of Thoracic Surgery, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | | | | | | | | |
Collapse
|
206
|
Abstract
Uterine arteriovenous malformation (AVM) is a little known condition of which, to date, very few cases have been described. It has a very diverse symptomatology, even though in most cases, it is diagnosed during a severe and acute haemorrhagic event. Its treatment can vary from expectant management to hysterectomy; however, current evidence suggests that the embolisation of uterine arteries is the most effective approach, especially if fertility is to be preserved. We present a case report classified as AVM, with additional images that show the appearance of this pathology in a short span of time. This case has a number of peculiarities: unusual persistence of human chorionic gonadotropin hormone (β-HCG), asymptomatic patient, quick establishment of the lesion and its duration with unchanging characteristics and finally its spontaneous resolution without further consequences. This entity shows an aetiopathogenesis, that is, not well established or described. We discuss its physiopathology and aetiopathogenesis.
Collapse
Affiliation(s)
- Francisco Sellers
- Department of Obstetrics, Bernabeu Institute, Alicante, Alicante, Spain
| | | | | | | |
Collapse
|
207
|
Coca J, Romero R, Sanchez-Orgaz M, Arbizu A, Frutos-Martinez R, Fernandez-Prieto A, Marin-Aguilera B. Use of carotid compression in a patient with arteriovenous malformation. Orbit 2013; 32:63-66. [PMID: 23387461 DOI: 10.3109/01676830.2012.747210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We report a case of a patient with a high flow arteriovenous malformation (AVM)i n the orbit, who developed a severe compartment syndrome, and was successfully treated with manual carotid compressions. The patient suffered a progressive proptosis, restriction of ocular motility and decreased of the visual acuity of the right eye. Embolization had a high risk of serious complications due to fistula location, so an alternative treatment consisting in carotid compressions was prescribed. Manual carotid compression is a non-invasive alternative technique to treat AVMs in patients with high risk of embolization episodes.
Collapse
Affiliation(s)
- Javier Coca
- Department of Ophtalmology of University Hospital La Paz, Madrid, Spain
| | | | | | | | | | | | | |
Collapse
|
208
|
Parshin VD, Biriukov IV, Puretskiĭ MV, Parshin VV, Ippolitov LI, Khuan I. [Surgical and endovascular treatment of lung arteriovenous malformations]. Khirurgiia (Mosk) 2013:4-11. [PMID: 24300571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The article summarizes the experience of surgical treatment of 47 patients (1964-2012 yy) with lung arteriovenous malformations (LAVM). Men were 29, women - 18. Age varied from 6 to 49 years. 20 patients had solitary lung arteriovenous malformations, the rest 27 had multiple malformations. Before 1983 the main diagnostic means was the angiopulmonography, since that the multyspiral computed tomography has been used. Before 1980 all patients received major surgical treatment, i.e., lobectomy (n=29), pneumonectomy (n=1) and 1 explorative thoracotomy. After 1980 the endovascular embolisation under the X-ray control took the leading place among the treatment options for these patients. 11 patients had 17 embolisations; the lung resection was performed only in 3 cases. All negative outcomes (4 lethal and 8 complications) were registered before the 1980. The were no lethal outcomes after the endovascular embolisation; only 3 patients had complications. All patients demonstrated satisfactory and good outcomes, considering objective parameters and quality of life early and long after the endovascular embolisation.
Collapse
|
209
|
Kochhar PK, Sarangal M, Gupta U. Conservative management of cesarean scar pregnancy with uterine arteriovenous malformation: a case report. J Reprod Med 2013; 58:81-84. [PMID: 23447926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Cesarean scar pregnancy is a rare type of ectopic pregnancy in which implantation occurs in a previous lower segment cesarean scar. It may be associated with uncontrolled hemorrhage ending in hysterectomy. It can become potentially life threatening for the patient when it further gets complicated by uterine arteriovenous malformation (AVM). To the best of our knowledge there are only a few previous reports of AVM complicating a scar pregnancy. It is still unclear which treatment is most optimal. CASE We describe a case of a scar pregnancy complicated by uterine AVM. The diagnosis was made using 3D color Doppler ultrasound, showing a highly vascular tumor in the isthmic region of the uterus. Computed tomography angiography supported the diagnosis. The patient underwent selective embolization of the uterine artery followed by weekly intramuscular injections of methotrexate. Recovery was uneventful. CONCLUSION The decision regarding mode of treatment should be made by the patient and the clinician based on the local expertise and experience. Judicious use of medical management (methotrexate) and uterine artery embolization may prevent hysterectomy and allow preservation of fertility.
Collapse
Affiliation(s)
- Puneet Kaur Kochhar
- Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India.
| | | | | |
Collapse
|
210
|
Koubaa M, Lahiani D, Mâaloul I, Fourati H, Chaari L, Marrakchi C, Mnif Z, Boudawara Z, Ben Jemâa M. Actinomycotic brain abscess as the first clinical manifestation of hereditary hemorrhagic telangiectasia--case report and review of the literature. Ann Hematol 2012; 92:1141-3. [PMID: 23274357 DOI: 10.1007/s00277-012-1666-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 12/21/2012] [Indexed: 12/01/2022]
|
211
|
Yeh CH, Wu YM, Chen YL, Wong HF. Contralateral de novo intraosseous arteriovenous malformation in a child with arteriovenous malformation of mandible treated by endovascular embolotherapy. A case report. Interv Neuroradiol 2012; 18:484-9. [PMID: 23217644 DOI: 10.1177/159101991201800415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Accepted: 08/12/2012] [Indexed: 11/15/2022] Open
Abstract
We describe our experience of the development of contralateral de novo intraosseous AVMs in a ten-year-old girl with AVMs of the mandible who underwent endovascular embolotherapy. She initially presented with intermittent oral bleeding. Computed tomography and digital subtraction angiography demonstrated intraosseous AVMs within the right mandible. The AVMs were treated by transosseous direct-puncture and transarterial embolization with Guglielmi detachable coils and n-butyl cyanoacrylate glue. However, de novo intraosseous AVMs developed within the previously healthy contralateral mandible and resulted in dangerous oral bleeding. Therefore, we suggest regular follow-up and prompt retreatment of any residual mandibular AVMs in patients undergoing endovascular or surgical treatment to prevent subsequent development of "secondary" AVMs and life-threatening oral bleeding.
Collapse
Affiliation(s)
- C-H Yeh
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | | | | | | |
Collapse
|
212
|
|
213
|
Sinkovskaya E, Abuhamad A, Horton S, Chaoui R, Karl K. Fetal left brachiocephalic vein in normal and abnormal conditions. Ultrasound Obstet Gynecol 2012; 40:542-548. [PMID: 22461379 DOI: 10.1002/uog.11166] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To establish values of fetal left brachiocephalic vein (LBCV) dimensions during normal pregnancy and determine whether routine assessment of the LBCV may help in identifying fetuses with congenital abnormalities of this vessel. METHODS Fetal LBCV was assessed prospectively during ultrasound examinations in 431 normal singleton pregnancies. The visualization rate of the transverse view of the upper fetal chest at the level of drainage of the LBCV into the superior vena cava (SVC) by two-dimensional (2D) and 2D plus color Doppler ultrasound was evaluated. Reference ranges of LBCV diameter during non-complicated pregnancies were established. Interobserver and intraobserver measurement variability was analyzed. In addition, a retrospective review of the hospital medical records of 91 pregnancies with fetuses diagnosed with LBCV abnormalities was performed. RESULTS Sonographic assessment of the fetal LBCV was consistently achieved in the second and third trimesters and in some fetuses in the first trimester of pregnancy. In normal fetuses LBCV diameter increased significantly throughout pregnancy, with a mean value of 0.7 mm at 11 weeks and 4.9 mm at term. Dilation of the fetal LBCV was noted in five cases of intracranial arteriovenous malformation and six cases of supracardiac type total anomalous pulmonary venous connection. Abnormal course of the LBCV was noted in 12 fetuses. In 63 fetuses with a persistent left SVC and a right SVC the LBCV was absent. CONCLUSION This is the first study describing an effective sonographic approach for the assessment of fetal LBCV dimensions during pregnancy. The normative data may provide an additional means of detecting rare anomalies of systemic and pulmonary veins during pregnancy.
Collapse
Affiliation(s)
- E Sinkovskaya
- Division of Maternal-Fetal Medicine of the Department of Obstetrics & Gynecology, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
| | | | | | | | | |
Collapse
|
214
|
Raja W, Yousef A, Ahmed MI, Waheed S. Neurofibromatosis-1 with intraventricular haemorrhage and pectus excavatum. J Coll Physicians Surg Pak 2012; 22:669-970. [PMID: 23058156 DOI: 10.2012/jcpsp.669670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/07/2012] [Indexed: 06/01/2023]
Abstract
This case report describes the occurrence of intraventricular haemorrhage in a teenage boy, who was later found to have neurofibromatosis-1, cerebral vascular disease and pectus excavatum.
Collapse
Affiliation(s)
- Waseem Raja
- Department of Neurology, Military Hospital, Rawalpindi, Pakistan.
| | | | | | | |
Collapse
|
215
|
López V, López I, Ricart JM. Temporary alopecia after embolization of an arteriovenous malformation. Dermatol Online J 2012; 18:14. [PMID: 23031381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Alopecia after head and neck radiotherapy has been extensively reported in the literature. However, alopecia after endovascular procedures is seldom reported in the dermatological literature. Prolonged fluoroscopic imaging during these procedures may cause serious radiation injuries to the skin, such as dermatitis or alopecia. Radiation-induced temporary alopecia is a peculiar form of radiodermitis that occurs over the areas of the scalp that receive the highest doses of radiation. Although repopulation of alopecic patches occurs spontaneously without treatment, it is important to recognize this disorder to establish a correct diagnosis and inform patients about this transient side effect. We report a 44-year-old woman presenting with temporary alopecia after embolization of an arteriovenous malformation.
Collapse
|
216
|
Baccaro L, Ogu S, Sakharpe A, Ibrahim G, Boonswang P. Rectal dieulafoy lesions: a rare etiology of chronic lower gastrointestinal bleeding. Am Surg 2012; 78:E246-E248. [PMID: 22691315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Leopoldo Baccaro
- Department of General Surgery, Easton Hospital, Easton, Pennsylvania, USA.
| | | | | | | | | |
Collapse
|
217
|
Recto MR, Stohs M, Yeh T. Contraction of the Amplatzer Vascular Plug I and II in pulmonary artery and systemic venous collateral vessels is safe and of no hemodynamic or vascular consequence in short- and mid-term follow-up. J Invasive Cardiol 2012; 24:145-150. [PMID: 22477747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The Amplatzer Vascular Plug (AVP) I and AVP II have been used successfully to occlude moderate-large venous collateral vessels (VC) and pulmonary arteriovenous malformations (PAVM) in children and adults with congenital heart disease. PURPOSE To report our experience in 4 patients who underwent device occlusion of systemic venous collaterals (3 patients) and device closure of pulmonary arteriovenous malformation (1 patient) that developed contraction of the AVP. METHODS The records of all patients who underwent device occlusion utilizing both AVP I and AVP II between November 2006 and January 2011 were retrospectively reviewed. All available follow-up chest x-rays were reviewed and compared with angiograms obtained post device occlusion. A device 30%-50% larger than the targeted vessel was utilized to occlude the vessel. RESULTS Four patients were identified with a mean age of 21 years (range, 7 years and 2 months-52 years) and mean weight of 60.6 kg (range, 15.3-131.5 kg). Two patients received AVP I and 2 patients received AVP II. One patient who received the 12 mm AVP I showed moderate contraction. The 3 other patients who received AVP I (6 mm) and AVP II (10 mm, 12 mm) all demonstrated device contraction to the original shape of the device. Mean follow-up time of 24 months (range, 12-40 months) has shown no evidence of hemodynamic or vascular compromise. CONCLUSIONS Short to mid-term follow-up indicate that contraction of AVP I and AVP II is safe with no evidence of hemodynamic or vascular compromise. Continued long-term follow-up is warranted.
Collapse
Affiliation(s)
- Michael R Recto
- Tulane University Section of Pediatric Cardiology, 1430 Tulane Avenue, SL-22, New Orleans, LA 70112, USA.
| | | | | |
Collapse
|
218
|
Lv X, Li Y, Yang X, Jiang C, Wu Z. Endovascular embolization for symptomatic perimedullary AVF and intramedullary AVM: a series and a literature review. Neuroradiology 2012; 54:349-59. [PMID: 21556862 DOI: 10.1007/s00234-011-0880-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 04/20/2011] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Perimedullary arteriovenous fistula (AVF) has shunt on the spinal cord surface and it can be treated with surgery, or endovascular embolization. Intramedullary arteriovenous malformation (AVM) has its nidus in the cord and is difficult to treat either by surgery or endovascular technique. We report our experience with endovascular embolization in the treatment of perimedullary AVF and intramedullary AVM. METHODS Four consecutive cases of spinal perimedullary AVF and six intramedullary AVM were retrospectively reviewed. These cases were evaluated and treated at Beijing Tiantan Hospital, China, over a 2-year period. A review of previously reported cases was also performed. RESULTS There was no significant difference in the presentations (P = 0.348), level of lesions (P = 0.350), arterial suppliers (P = 0.801), and associated vascular anomalies between perimedullary AVF and intramedullary AVM, except for age (P = 0.014) and treatment modalities (P = 0.003). The patients with perimedullary AVFs were younger in our cases; the age at onset of symptoms averaged 25.8 years compared to 31.7 years for intramedullary AVMs. There was a significant male predominance for both lesions, and a significantly higher incidence of subarachnoid hemorrhage than in spinal dural AVFs. Regarding treatment, endovascular coil embolization is frequently used in perimedullary AVF and liquid embolic agent is an effective therapeutic choice in intramedullary AVM. CONCLUSION Perimedullary AVF and intramedullary AVM are dissimilar with dural AVF in clinical characteristics. Our experience suggests that the endovascular treatment of spine perimedullary AVFs and intramedullary AVMs is feasible and effective. Endovascular treatment for intramedullary AVMs is still challenging, the main problem is acute ischemia injury of the spinal cord.
Collapse
Affiliation(s)
- Xianli Lv
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No.6, Tiantan Xili, Chongwen, Beijing 100050, People's Republic of China
| | | | | | | | | |
Collapse
|
219
|
Kanenishi K, Mashima M, Tanaka H, Nagasaka H, Toyama Y, Hata T. Transvaginal 3D HD-flow in diagnosis of uterine arteriovenous malformation. Arch Gynecol Obstet 2012; 286:541-4. [PMID: 22392491 DOI: 10.1007/s00404-012-2284-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 02/23/2012] [Indexed: 11/25/2022]
|
220
|
Abstract
Pulmonary arteriovenous malformations (PAVMs) are caused by abnormal communications between pulmonary arteries and pulmonary veins. They are most often congenital, and may occur as isolated lesions or part of complex congenital syndromes. We describe a case of PAVM in a 16-week-old fetus. To the best of our knowledge this is the first case to be described in the literature of diagnosis, at such an early gestational age, of PAVM with the shunt found between the main pulmonary artery and pulmonary vein.
Collapse
Affiliation(s)
- G Akler
- Department of Pediatric Cardiology, Edith Wolfson Medical Center, Holon, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | |
Collapse
|
221
|
Do YS, Kim YW, Park KB, Kim DI, Park HS, Cho SK, Shin SW, Park YJ. Endovascular treatment combined with emboloscleorotherapy for pelvic arteriovenous malformations. J Vasc Surg 2012; 55:465-71. [PMID: 22051867 DOI: 10.1016/j.jvs.2011.08.051] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 08/23/2011] [Accepted: 08/26/2011] [Indexed: 12/30/2022]
Affiliation(s)
- Young Soo Do
- Department of Radiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
222
|
Tkachev VV, Lepshokov MK, Kran OI, Muzlaev GG. [Combination of multiple distal posterior fossa aneurysms with cerebellar AVM]. Zh Vopr Neirokhir Im N N Burdenko 2012; 76:48-52. [PMID: 23230694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A rare combination of distal aneurysms of SCA and PICA with cerebellar AVM is presented. Case report demonstrates successful simultaneous surgical treatment of all abovementioned anomalies.
Collapse
|
223
|
Manzelli A, Rossi P, Petrou A, De Sica G, Ricciardi E, Pappas P. Use of intraoperative endoscopy to localize bleeding in the small intestine. Ann Ital Chir 2012; 83:29-33. [PMID: 22352213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Bleeding within the small intestine is difficult to diagnose and localize because it typically occurs at a slow rate. These patients may undergo multiple transfusions and repeated endoscopy, contrast studies, bleeding scans, and angiography before the bleeding source is identified. CASE REPORT We report a case of 64-year-old woman, where both endoscopic and angiographic techniques were used to localize protracted bleeding. During endoscopic treatment, the arteriovenous malformations continued bleeding. However, highly selective angiography and intraoperative endoscopy outlined the segments of small intestine for resection. This case reviews the evaluation, localization and treatment of small intestine bleeding. DISCUSSION Localizing the site of protracted bleeding in the small intestine beyond the duodenum bulb can be problematic. For some patients, the course of examinations and transfusions can take years. The small intestine is an uncommon site for gastrointestinal hemorrhage, and only 3%-5% of gastrointestinal bleeding occurs between the ligament of Treitz and the ileocecal valve. The length and location of the small intestine, along with other anatomical factors, make this area difficult to assess with endoscopy or radiology. In this case of protracted bleeding, highly selective angiography and intraoperative endoscopy were used to locate the source of the bleeding.
Collapse
Affiliation(s)
- Antonio Manzelli
- Dipartimento di Chirurgia D'Urgenza, Senologica e dei Trapianti, Policlinico Tor Vergata, Roma, Italy
| | | | | | | | | | | |
Collapse
|
224
|
Abstract
Splanchnic arteriovenous malformation (AVM) is a rare condition in which patients present with portal hypertension, which thus causes bleeding varices and ascites. However, to our knowledge, hepatic nodules associated with splanchnic AVM have not yet been described. We herein first report the case of a 78-year-old man with inferior mesenteric AVM presenting with portal hypertension and multiple hepatic nodules dominantly supplied by the portal vein. This unique case not only extends the spectrum of hepatic nodules resulting from abnormal hepatic circulation, but also provides clues for better understanding the etiology of hepatic nodules.
Collapse
Affiliation(s)
- Ken Takahashi
- Department of Gastroenterology and Hepatology, Kobe City General Hospital, Japan.
| | | | | |
Collapse
|
225
|
Vaknin Z, Sadeh-Mefpechkin D, Halperin R, Altshuler A, Amir P, Maymon R. Pregnancy-related uterine arteriovenous malformations: experience from a single medical center. Ultraschall Med 2011; 32 Suppl 2:E92-E99. [PMID: 21614746 DOI: 10.1055/s-0031-1273274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE The purpose of this article was to investigate clinical ultrasonographic findings and the outcomes of post-pregnancy patients with acquired uterine vascular abnormalities including arteriovenous malformations (AVMs). MATERIALS AND METHODS We performed a computerized database search for all patients with ultrasonographic findings of a vascular abnormality including AVM in our referral center between 2000-2008. An ultrasound finding of vascular abnormality was defined as an area of strong hypervascularity within the myometrium and the presence of marked turbulence. The inclusion criteria for angiography were abnormal vaginal bleeding in a hemodynamically stable patient, bhCG serum levels ≤ 30 mIU/ml, and ultrasound demonstration of large (≥ 15 mm on the larger side of the vessel) or multiple vascular lesions. RESULTS 16 women were identified, of whom 10 (63 %) underwent uterine artery embolization. Angiography confirmed the pre-interventional ultrasound diagnosis of AVM in all cases. AVM feeding arteries were on the left side of the uterus in 80 % of the cases. Residual tissue was ultrasonographically detected in five patients: 2 underwent hysteroscopy and guided curettage following embolization and three received methotrexate. All tissue samples were benign. One small vascular abnormality resolved spontaneously. CONCLUSION An acquired uterine vascular abnormality including AVM should be considered in the work-up of post-pregnancy vaginal bleeding.
Collapse
Affiliation(s)
- Z Vaknin
- Department of Obstetrics and Gynecology Assaf Harofe Medical Center, Zerifin, Israel
| | | | | | | | | | | |
Collapse
|
226
|
Akbayir O, Gedikbasi A, Akyol A, Ucar A, Saygi-Ozyurt S, Gulkilik A. Cesarean scar pregnancy: a rare cause of uterine arteriovenous malformation. J Clin Ultrasound 2011; 39:534-538. [PMID: 21647920 DOI: 10.1002/jcu.20848] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2010] [Accepted: 04/06/2011] [Indexed: 05/30/2023]
Abstract
A 38-year-old gravida 4, para 2 woman with a history of two Cesarean sections and one curettage was referred to our hospital, because of painless vaginal bleeding and 6 weeks + 2 days of amenorrhea. The first diagnosis was Cesarean scar pregnancy, managed with methotrexate. Subsequently, an arteriovenous malformation developed, which was diagnosed with color Doppler imaging. The diagnosis was confirmed with angiography. Successful bilateral uterine artery embolization was performed with ethylene vinyl alcohol copolymer (Onyx), n-butyl-2-cyanoacrylate (Histoacryl), and gelfoam.
Collapse
Affiliation(s)
- Ozgur Akbayir
- Istanbul Bakirkoy Maternity and Children Diseases Hospital, Department of Obstetrics and Gynecology, Oncology Unit, Istanbul, Turkey
| | | | | | | | | | | |
Collapse
|
227
|
Degrugillier-Chopinet C, Bisdorff-Bresson A, Laurian C, Breviere GM, Staumont D, Fayoux P, Lenica D, Gautier C. [Role of duplex Doppler for superficial "angiomas"]. J Mal Vasc 2011; 36:348-54. [PMID: 22015041 DOI: 10.1016/j.jmv.2011.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 08/09/2011] [Indexed: 11/19/2022]
Abstract
Diagnosis of superficial vascular anomalies, previously called "angiomas", is basically clinical. Ultrasound and duplex Doppler imaging is a simple and helpful tool to confirm the clinical diagnosis and/or to suggest further required imaging modalities. The purpose of this work is to demonstrate the usefulness of duplex Doppler and ultrasound for exploring vessel and soft tissue components of vascular anomalies.
Collapse
Affiliation(s)
- C Degrugillier-Chopinet
- Service de Neuroradiologie, Hôpital Roger-Salengro, CHRU de Lille, 59037 Lille cedex, France.
| | | | | | | | | | | | | | | |
Collapse
|
228
|
|
229
|
Kishi K, Shirai S, Sato M, Sonomura T. Role of external beam radiotherapy for arteriovenous malformation of the pancreas. Jpn J Radiol 2011; 29:517-20. [PMID: 21882095 DOI: 10.1007/s11604-011-0578-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 02/21/2011] [Indexed: 11/27/2022]
Abstract
Pancreatic arteriovenous malformation (PAVM) is rare and is mainly reported from Asian countries. We incidentally encountered an asymptomatic, early-stage PAVM in a patient who presented with portal venous distention, Child B liver cirrhosis, and hepatoma. The PAVM had multiple feeding arteries and drainage into the portal vein and varices. Because surgery was not indicated, after considering the risks and bene-fits the patient chose treatment with 40 Gy of conformal radiotherapy for 4 weeks. Computed tomography performed 6 months later revealed reduction in the size of the PAVM. Treatment had lasting effects for 18 months without significant toxicity. As observed in many reports of radiotherapy for various AVMs, the radiotherapy may stall self-augmenting growth of the AVM. Conventional fractionated radiotherapy of 40 Gy may be a useful choice for early-stage PAVM.
Collapse
Affiliation(s)
- Kazushi Kishi
- Department of Radiation Oncology, Tumor Center, Wakayama Medical University Hospital, 811-1 Kimiidera, Wakayama 641-8510, Japan.
| | | | | | | |
Collapse
|
230
|
Marks JA, Martin ND, Jenoff JS, Weinstein MS. Occult pulmonary arteriovenous malformation resulting in acute mesenteric ischemia and post-operative respiratory failure. Am Surg 2011; 77:1096-1098. [PMID: 21944533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Joshua A Marks
- Division of Acute Care Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | | | | |
Collapse
|
231
|
Abstract
Most pancreatic arteriovenous malformations (PAVM) present due to gastrointestinal bleeding or abdominal pain, but these patients may be asymptomatic. Increased portal vein flow from these malformations can lead to portal hypertension and gastrointestinal bleeding. Diagnosis is often made by imaging, and early diagnosis has led to successful surgical resection or percutaneous embolization. We report a patient with PAVM, diagnosed by CT and angiography, who has remained asymptomatic for 2 years without treatment.
Collapse
Affiliation(s)
- Damon D Shearer
- Radiology Dept, Loyola University Medical Center, Maywood, IL 60153, USA
| | | | | |
Collapse
|
232
|
Gadodia A, Sharma R, Kandpal H, Prashad R. Congenital absence of portal vein with large inferior mesenteric-caval shunt. Trop Gastroenterol 2011; 32:223-226. [PMID: 22332341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Ankur Gadodia
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi-110029, India
| | | | | | | |
Collapse
|
233
|
Scardapane A, Stabile Ianora A, Sabbà C, Moschetta M, Suppressa P, Castorani L, Angelelli G. Dynamic 4D MR angiography versus multislice CT angiography in the evaluation of vascular hepatic involvement in hereditary haemorrhagic telangiectasia. Radiol Med 2011; 117:29-45. [PMID: 21643641 DOI: 10.1007/s11547-011-0688-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Accepted: 07/12/2010] [Indexed: 01/17/2023]
Abstract
PURPOSE Hereditary haemorrhagic telangiectasia (HHT), or Rendu-Osler-Weber disease, is a rare autosomal dominant disorder characterised by mucocutaneous or visceral vascular abnormalities that may be widely distributed throughout the cardiovascular system. The purpose of this study was to compare multislice computed tomography angiography (MSCTA) and 4D dynamic contrast-enhanced magnetic resonance angiography (D-MRA) for evaluating vascular hepatic involvement in patients with HHT. MATERIALS AND METHODS Fifty-two consecutive HHT patients underwent MSCTA and D-MRA examinations for systematic analysis of vascular visceral involvement. The images from the two techniques were reviewed independently by two expert radiologists to identify the following vascular abnormalities: telangiectases or large vascular masses; perfusion disorders [transient hepatic attenuation differences (THADs)]; hepatic arteriovenous malformations (HAVMs). Data, as well as diameters of the common hepatic artery and portal vein, were compared with Cohen's kappa statistic, Student's t test and receiver operating characteristic (ROC) curve analysis, as appropriate. RESULTS Both MSCTA and D-MRA detected one or more of the following hepatic vascular abnormalities in 36/52 cases (telangiectases in 29/52, THADs in 23/52 and HAVMs in 25/52[CE1]). A good concordance was found between the two techniques when determining the type of hepatic shunt (κ=0.9). No statistically significant differences were found when comparing mean common hepatic artery and portal vein diameters (p=0.09 and 0.22, respectively) and their accuracy in predicting HAVMs. CONCLUSIONS D-MRA has the same diagnostic accuracy as MSCTA and has the advantage of being less invasive due to the absence of ionising radiation.
Collapse
Affiliation(s)
- A Scardapane
- Section of Radiology, Di.M.I.M.P., HHT Interdepartmental Centre, University Hospital, Policlinico of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.
| | | | | | | | | | | | | |
Collapse
|
234
|
Vijayakumar S, Kurian VM, Ravikumar R, Mullasari Ajit S, Ulhas Pandurangi M. An unusual combination of coronary arterial and systemic venous anomalies-clinical implications. Indian Heart J 2011; 63:275-276. [PMID: 22734350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
A 57-year-old male underwent coronary angiography for exertional angina which showed two left anterior descending coronary arteries (LAD)--a short LAD from the left coronary sinus terminating in the proximal Anterior Inter-Ventricular Sulcus (AIVS), a long LAD from the proximal right coronary artery entering the distal AIVS and an anomalous left circumflex artery from the right coronary sinus. In addition, he also had absent right superior vena cava and a persistent left superior vena cava entering the coronary sinus.
Collapse
Affiliation(s)
- S Vijayakumar
- Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu. India.
| | | | | | | | | |
Collapse
|
235
|
Affiliation(s)
- Sarah Louise Bell
- Department of Stroke Medicine, Leicester General Hospital, University Hospitals of Leicester, UK
| | | |
Collapse
|
236
|
Liu W, Shi ZJ, Wang LC, Ping FY. [Clinical application of radiotherapy for the treatment of giant vascular malformations in oral and maxillofacial region]. Zhonghua Kou Qiang Yi Xue Za Zhi 2011; 46:201-204. [PMID: 21612706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To discuss the clinical use of radiotherapy in the treatment of giant vascular malformation. METHODS Six patients with giant vascular malformation in oral and maxillofacial region were treated by three dimensional radiation therapy in Department of Stomatology, The Second Affiliated Hospital, School of Medicne, Zhejiang University in the last ten years and the cilinical data were reviewed. The treatment results were evaluated by clinical examination and radiology. RESULTS No complication was observed during and after the radiotherapy. All patients were satisfied with the aesthetic results. The lesions in MRI were all reduced and even disappeared. There was no sign of recurrence during the follow-up period. CONCLUSIONS Three dimensional radiotherapy is safe and effective for oral and maxillofical vascular malformation.
Collapse
Affiliation(s)
- Wei Liu
- Department of Stomatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | | | | | | |
Collapse
|
237
|
Macri A, Pleşiţă A, Alexandru T, Stoica RT, Mihălţan F. [Rare case of multiple pulmonary nodules--a case report]. Pneumologia 2011; 60:87-92. [PMID: 21823360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The article presents the case of a 44 years old female patient admitted in the hospital for a solitary pulmonary nodule discovered through a chest X-ray performed for left thoracic pain. Despite the young age, a lot of comorbidities were present: severe dyslipidemia, ischemic right cerebellar lesion, degenerative periventricular lesions, chronic autoimmune thyroiditis, uterine fibroma, fibrocystic mastitis, polyglobulia of uncertain etiology and Rendu-Osler disease. The investigation which showed the nature of the pulmonary nodule was the CT scan with intravenous contrast, which demonstrated that the nodules were in fact arterial-venous malformations as part of the Rendu-Osler disease. This case offers the opportunity to discuss about etiopathogeny, morphopathology, criteria of diagnosis and treatment principles in Rendu-Osler disease.
Collapse
Affiliation(s)
- Anca Macri
- Institutul de Pneumoftiziologie "Marius Nasta" Bucureşti.
| | | | | | | | | |
Collapse
|
238
|
Mangold S, Ketelsen D, Syha R, Balletshofer B, Kalender G, Kramer U, Claussen CD, Brechtel K. Endovascular treatment of a real inferior gluteal artery aneurysm associated with a pelvic arteriovenous malformation. Cardiovasc Intervent Radiol 2011; 34:1102-5. [PMID: 21431977 DOI: 10.1007/s00270-011-0131-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
239
|
Syla BH, Fetiu SS, Tafarshiku SS. Transabdominal two- and three-dimensional color Doppler imaging of a uterine arteriovenous malformation. Ultrasound Obstet Gynecol 2011; 37:376-378. [PMID: 21337661 DOI: 10.1002/uog.8918] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- B H Syla
- Gynecologic Private Office Dr Bajrami, Ferizaj, Kosovo.
| | | | | |
Collapse
|
240
|
Kjeldsen AD, Andersen PE, Tørring PM. [Diagnosis and treatment of morbus Osler]. Ugeskr Laeger 2011; 173:490-495. [PMID: 21320413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Morbus Osler or hereditary haemorrhagic telangiectasia (HHT) is a genetic disorder resulting in development of arteriovenous malformations in the mucosa and in visceral organs. The most common symptom is epistaxis. The disease may, however, cause a variety of other serious manifestations such as pulmonary arteriovenous malformations (PAVM), cerebral arteriovenous malformations (CAVM) and gastrointestinal bleeding. Collaboration between various medical specialties is essential in order to provide an up-to-date treatment and thorough work-up in the individual patient. Disregard of symptoms may result in substantial morbidity and may have serious consequences. This overview presents our current understanding of HHT.
Collapse
Affiliation(s)
- Anette Drøhse Kjeldsen
- Øre-næse-hals-kirurgisk Afdeling F, Odense Universitetshospital, 5000 Odense C, Denmark.
| | | | | |
Collapse
|
241
|
Hammad FT, Shawish F, Kazim E. Congenital pelvic arteriovenous malformation presenting with urinary retention: a case report. Med Princ Pract 2011; 20:294-6. [PMID: 21455004 DOI: 10.1159/000323837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 10/07/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To report a case of congenital pelvic arteriovenous malformation (pAVM) with urinary retention. CLINICAL PRESENTATION AND INTERVENTION A 39-year-old male patient presented with inability to void urine for 8 h. He did not have a history of dysuria or fever, but had increasing urinary frequency and difficulty in voiding over 2 years. Examination revealed a suprapubic mass without external signs of vascular anomaly. A huge, soft, irregular, non-pulsating mass was felt rectally. This mass did not disappear on urinary bladder decompression. Subsequent ultrasound and CT scan revealed pAVMs filling most of the pelvic cavity. CONCLUSION To our knowledge, this is the first report of a male patient with congenital pAVM presenting with urinary retention, emphasizing the need for a high index of suspicion for pAVM to avoid potential severe bleeding during suprapubic catheterization for urinary drainage.
Collapse
Affiliation(s)
- Fayez T Hammad
- Department of Surgery, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | | | | |
Collapse
|
242
|
Colotto M, Da Ros S, Barbarossa G, Renzi A, Vinci F, Coletta P, Maria Salvatori F. Atrial fibrillation and right bundle branch block complicating coil embolization of a huge pulmonary arterio-venous malformation. Intern Med 2011; 50:2983-6. [PMID: 22185989 DOI: 10.2169/internalmedicine.50.6136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Coil embolization is a safe therapy for pulmonary arterio-venous malformations (PAVMs). We report the case of a 72-year-old woman affected by hereditary hemorrhagic teleangectasia who experienced right bundle branch block and atrial fibrillation 36 hours after embolization of an extended PAVM. To our knowledge, this is the first case of such a complication of embolization of a pulmonary fistula, presumably due to an acute pressure overload on both the right atrium and ventricle. This case report suggests that, after embolization of extended pulmonary fistulas, patients should be carefully monitored for rhythm disturbance and new onset of intraventricular conduction defects.
Collapse
Affiliation(s)
- Marco Colotto
- Department of Internal Medicine and Medical Specialties, Sapienza University-Policlinico Umberto I-Rome, Italy.
| | | | | | | | | | | | | |
Collapse
|
243
|
Das M, Odisio E, Loyalka P, Cheong BYC. Large pulmonary arteriovenous malformation diagnosed by cardiovascular magnetic resonance. Tex Heart Inst J 2011; 38:308-309. [PMID: 21720481 PMCID: PMC3113126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
WEB SITE FEATURE
Collapse
Affiliation(s)
- Manisha Das
- Department of Radiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA
| | | | | | | |
Collapse
|
244
|
|
245
|
Oueis H, Geist JR, Tran MU, Stenger J. High-flow arteriovenous malformations of the mandible and the maxilla: report of 2 cases. Pediatr Dent 2010; 32:451-456. [PMID: 21070715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Arteriovenous malformations (AVMs) are rare vascular lesions that can be life-threatening due to potential massive hemorrhage. AVMs can be subdivided according to the type of vessel involved (capillary, venous, and arterial) and can be categorized, according to hemodynamic features, into high-flow and low-flow lesions. AVM of the jaws is an uncommon disease. Clinical signs and symptoms of AVM may include pain, erythematous gingiva, spontaneous gingival bleeding, resorption and mobility of teeth, soft tissue discoloration, facial swelling, and asymmetry. Radiographically, AVMs are osteolytic and frequently have indistinct margins. Computed tomography can demonstrate enhancement of the lesions, while angiography can depict distended feeder vessels and arteriovenous shunts. Magnetic resonance imaging can visualize flow voids in high-flow abnormalities. The purpose of this paper was to present 2 high-flow cases of arteriovenous malformations: one with a large AVM lesion in the mandible that presented clinically as a discoloration on the mucosa and gingiva with loss of lip sensation; and the second with a lesion in the maxilla discovered during an extraction of a root fragment. Management of the lesions was achieved by embolization.
Collapse
Affiliation(s)
- Hassan Oueis
- Department of Pediatric Dentistry, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA.
| | | | | | | |
Collapse
|
246
|
Easter JS, Josephson SA, Vinton DT, Saint S, Edlow JA. Clinical problem-solving. All in the family. N Engl J Med 2010; 362:2114-20. [PMID: 20519683 DOI: 10.1056/nejmcps0901416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Joshua S Easter
- Department of Emergency Medicine, Children's Hospital of Boston, MA, USA
| | | | | | | | | |
Collapse
|
247
|
Bradác O, Mayeroá K, Hrabal P, Benes V. Haemorrhage from a radiosurgically treated arteriovenous malformation after its angiographically proven obliteration: a case report. Cent Eur Neurosurg 2010; 71:92-95. [PMID: 20464791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Small lower-grade Spetzler-Martin arteriovenous malformations (AVMs) are mainly treated by microsurgical resection or stereotactic radiosurgery. The choice of treatment largely depends on the referring centre's preference and the patient's decision. We present here a patient with an AVM repeatedly treated at our Leksell Gamma Knife unit with radiographically confirmed obliteration of the AVM which subsequently began bleeding. This case demonstrates the possibility of late complications in radiosurgically treated AVMs even after their demonstrable obliteration. Meticulous histological examination was performed, proving patency of the AVM nidus. The risk of haemorrhagic complications of radiosurgically removed AVMs despite angiographic proof of their obliteration is, in our view, a cogent argument for preferring surgical resection if the AVM is accessible and for prolonged follow-up after radiosurgical treatment of an AVM.
Collapse
Affiliation(s)
- O Bradác
- Department of Neurosurgery, UVN Central Military Hospital, Charles University 1st Medical Faculty, Prague, Czech Republic.
| | | | | | | |
Collapse
|
248
|
Abstract
INTRODUCTION Arteriovenous malformations (AVMs) are rare in the oral and maxillofacial regions. DISCUSSION AVMs may induce severe complications such as uncontrollable bleeding. Superselective intra-arterial embolization is an effective method for this bleeding that is refractory to conservative treatment. Arterial embolization may cause ischemic complications. We report the case of a patient who developed face skin necrosis following bilateral facial artery embolization.
Collapse
Affiliation(s)
- Ozgür Tarkan
- ENT Department, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | | | | | | |
Collapse
|
249
|
Abstract
BACKGROUND The major consequence of pulmonary arteriovenous malformations (PAVMs) is the direct inflow of blood from the pulmonary artery to the pulmonary vein which induces hypoxemia. Severe complications include transient ischemic attacks, paradoxical embolization in the central nervous system, massive hemoptysis or hemothorax, etc. The conventional treatment is surgical intervention. However, this can be very traumatic and dangerous. Endovascular embolization has advantages over surgery such as a faithful therapeutic effect, a low complication rate, repeatability, etc. METHODS Patients (n = 23) with symptomatic PAVMs underwent endovascular embolization; 11 were males and 12 were females, with ages ranging from 6 months to 58 years. During the embolization, microcoils were applied in 6 cases and standard steel coils were used in 17 cases. RESULTS Multiple PAVMs lesions were found in 16 cases and single PAVMs lesion was found in 7 cases. Embolotherapy was carried out 28 times for 23 patients. The success rate was 100%. The results of pulmonary arteriography after treatment showed that single lesion disappeared completely while the main abnormal vessels in multiple lesions also disappeared. The mean blood oxygen saturation increased from (78.04 + or - 8.22)% to (95.13 + or - 3.67)% after the procedure. A correlated groups t test showed changes in blood oxygen saturation before and after embolization (t = 9.101, P < 0.001). Symptoms of cardiac insufficiency disappeared in 5 cases and vascular murmur in the chest disappeared in 13 cases. After embolization, mild chest pain occurred in 11 cases, small amounts of pleural effusion occurred in 5 cases, and 1 patient died 2 months later because of a pyogenic infection secondary to the pulmonary infarction. Among the 22 remaining cases, with overall follow-up ranging from 18 months to 12 years, general conditions were fine, daily lives were normal and there were no neurologic symptoms or signs, except for 3 patients with diffused PAVMs who had persistent blood oxygen saturation between 85% and 90%. Symptoms of hypoxia never recurred in the other cases. CONCLUSIONS Endovascular embolization of pulmonary arteriovenous malformations can significantly improve blood oxygen saturation and reduce serious complications such as cerebral infaction. Therefore, this kind of interventional procedure is a safe and effective treatment method with a low complication rate.
Collapse
Affiliation(s)
- Feng-yong Liu
- Department of Interventional Radiology, Clinical Division of Internal Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | | | | | | | | | | |
Collapse
|
250
|
Coombs PR, James PA, Edwards AG. Sonographic identification of lower limb venous hypoplasia in the prenatal diagnosis of Klippel-Trénaunay syndrome. Ultrasound Obstet Gynecol 2009; 34:727-729. [PMID: 19902468 DOI: 10.1002/uog.7461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report the prenatal identification of lower-limb venous hypoplasia to support a provisional prenatal diagnosis of Klippel-Trénaunay syndrome (KTS). Ultrasound assessment of a fetus with marked lower-limb edema, cystic areas in the abdomen/pelvis/lower limbs and abnormal development of the feet demonstrated bilateral hypoplasia of the femoral and popliteal veins. The external iliac veins and the great saphenous veins were seen to be normal. The lower limb arterial system was present. These findings supported KTS as the most likely provisional diagnosis, and postnatal clinical evaluation confirmed that the infant is best classified in the spectrum of KTS. Venous hypoplasia was confirmed with a postnatal ultrasound examination of the lower limbs. This case suggests that careful examination of the lower-limb venous system may be helpful in making the prenatal diagnosis of KTS.
Collapse
Affiliation(s)
- P R Coombs
- Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Ultrasound Department, Monash Medical Centre, Clayton, Australia.
| | | | | |
Collapse
|