ObjectiveTo explore the clinical characteristics and improve the knowledge of diagnosis and treatment of complex pulmonary arteriovenous fistula (PAVF) as well as enrich the experience of diagnosis and treatment of the disease.MethodsA retrospective analysis of pathogenetic process clinical manifestations, imaging features and diagnosis and treatment was conducted on one case of complex PAVF. The literature review was carried out with " complex pulmonary arteryovenous fistula (malformation)” as the research terms in English and Chinese respectively in CNKI, WanFang and PubMed database. Search time ranged from January 1997 to April 2018, and the literature was screened and reviewed.ResultsThe patient was a 47-year-old female complained of recurrent epistaxis for 40 years, intermittent hemoptysis for 20 years, headache, dizziness, chest pain, chest tightness for 4 years and the symptoms were aggravated by 3 months, visiting this hospital on January 23, 2018. Pulmonary CT angiography revealed multiple nodules in internal and external segment and outer basal segment of right lung, anterior basal segment and outer basal segment of left lung. CT enhanced scan showed that the thickened pulmonary artery was connected with the above lesion, and the edge was accompanied by large draining veins. Pulmonary artery revascularization showed complex PAVF abnormal branches. The diagnosis was complex PAVF, and interventional embolization therapy was carried out and curative effect was satisfactory during the follow-up. A total of 6 literatures were reviewed in above-mentioned databases, including 4 Chinese literatures and 2 English literatures, containing 10 patients, including 8 males and 2 females, with an average age of (9.7±7.0) years. Most of the clinical manifestations were shortness of breath after exercise, cyanosis and hemoptysis and all patients were cured and discharged after interventional embolization treatment except for 1 patient refused treatment.ConclusionsComplex PAVF is a very rare pulmonary vascular malformation. The clinical manifestations mainly include hypoxemia, dyspnea, hemoptysis, and the preferred treatment is interventional embolization, which has a satisfactory clinical effect at a short-term follow-up.
ObjectiveTo summarize and analyze the application of arteriovenous fistula plasty in elbow in hemodialysis. MethodsA retrospective analysis was made on the clinical data of 89 patients with chronic renal failure undergoing arteriovenous fistula plasty in elbow for hemodialysis between January 2010 and June 2012. The complications and operative success rate were analyzed. ResultsEighty-seven patients had successful fistula for hemodialysis; Three had acute left heart failure; Five had anastomotic thrombosis; and 2 had swollen hand syndrome. ConclusionThe choice of arteriovenous fistula plasty in elbow can be effective for hemodialysis, and can be used as a successful choice for the patients with poor conditions.
目的:探讨经肝动脉导管注射明胶海绵碘化油乳剂治疗肝癌合并严重动静脉瘘的可行性及临床应用价值。方法:对38例肝癌动静脉瘘患者血管分别行超选择插管注射明胶海绵碘化油乳剂,造影观察动静脉瘘的栓塞率,血管再通率,副作用,并发症及生存率等指标。结果:38例肝癌动静脉瘘患者经肝动脉导管注入明胶海绵碘化油乳剂约2~10mL栓塞,栓塞后造影显示闭塞率为94.7%(36/38),4周后造影显示动静脉瘘再通率为5.56%(2/36),未见确切不良反应,肿瘤碘化油乳剂沉积好,患者6月生存率为94.7%(36/38),12月生存率为60.5%(23/38),24月生存率为21.1%(8/38)。结论:经肝动脉导管注射碘化油乳剂治疗肝癌动静脉瘘安全可靠,对瘘口要求不高,栓塞率高,再通率低,肿瘤的栓塞治疗效果好。
目的 提高对创伤性假性动脉瘤并动静脉瘘的影像诊断水平。 方法 报告1例腰椎间盘手术所致的创伤性假性动脉瘤并动静脉瘘，比较分析MRA和DSA对该病的诊断价值。 结果 MRA能够明确创伤性假性动脉瘤及动静脉瘘的诊断，与DSA有良好的相关性。 结论 MRA对创伤性假性动脉瘤并动静脉瘘的确诊有重要价值，在一定程度上能够代替常规血管造影。
ObjectiveTo summarize the diagnosis and treatment experience of one case of abdominal aortic aneurysm with iliac arteriovenous fistula.MethodsA case of abdominal aortic aneurysm with left iliac arteriovenous fistula admitted to Nanchong Central Hospital in December 2019 was retrospectively analyzed. The diagnosis and treatment of the patient and the MDT discussion results were summarized.ResultsThe clinical manifestations of this patient was refractory heart failure, and he received heart medicine treatment in Nanchong Center Hospital. The patient diagnosed as abdominal aortic aneurysm with left iliac arteriovenous fistula after computed tomography angiography (CTA), abdominal aorta lumen coated stents isolation (EVAR) during operation was performed after the MDT discussion. Postoperative imaging revealed a tumor cavity abdominal aortic aneurysm and left iliac arteriovenous fistula completely closed, then the heart failure symptoms of the patient was quickly relieved. The whole operation went smoothly, with a duration of about 120 min and intraoperative blood loss of about 100 mL. The patient was discharged from hospital on the 7th day after the operation. CTA and color doppler ultrasound were rechecked in 3 months after the operation, and the stent was found to have unobtrusional blood flow and no internal leakage, and the pseudoaneurysm of the left iliac artery disappeared.ConclusionsFor patients with refractory heart failure, if accompanied by lower limb swelling, the possibility of arteriovenous fistula of the great vessels should be taken into account, and the medical history and physical examination should be collected comprehensively, and necessary examinations should be carried out timely to avoid missed diagnosis or misdiagnosis. Meanwhile, compared with traditional surgery, EVAR is a more reliable, minimally invasive, and safe treatment for abdominal aortic aneurysm with iliac arteriovenous fistula.