New capillary bed formation with a surgically constructed arteriovenous fistula

This study on 24 rats has demonstrated that neovascularization of the skin through an arteriovenous fistula is possible. A vascular bed can be created by the use of long interpositional vein grafts. An arteriovenous fistula in the shape of a loop could not only provide vascularity to create a skin flap of unlimited size but could possibly vascularize a digital replantation with severely damaged vessels and provide enough additional vascularity to facilitate the take of bone grafts and tissue composites.     

Duplex sonography of arteriovenous fistula in chronic hemodialysis patients

Duplex sonography was used to assess functional features of arteriovenous fistula (AVF) for hemodialysis (HD). Internal diameter (ID), resistance index (RI) and blood flow (BF) velocity in feeding artery and in vein ofAVF, and venous BF volume were analyzed with purpose to determine the normal values. Presumed normal BF velocities are those of clinically well functioning shunts, allowing BF through HD lines of minimally 250 ml/min. Study included 66 nondiabetic HDpatients (30 women, 36 men), mean age 52-13 years, treated by HD for median 61 (4-252) months. Measurements in 47patients with clinically well functioning AVF were as followed: mean arterial ID 5.2 +/- 1.4 mm, median arterial RI 0.3 (0.3-0.9), median arterial BF velocity 1.5 (0.6-3.6) m/s, mean venous ID 7.6 +/- 2.2 mm, median venous RI 0.3 (0.3-0.9), mean venous BF velocity 1.6 +/- 0.7 m/s, and median venous BF volume 530 (120-1890) ml/min. Patients with poor functioning AVF had significantly less arterial ID, higher arterial RI, less venous ID, less venous BF velocity and volume. Duplex sonography findings obtained for clinically estimated well functioning shunt should be considered as normal Doppler values. Blood vessels' morphologic features depend upon age, and older patients have more pronounced changes.     

Suppression of MMP-9 by doxycycline in brain arteriovenous malformations

Background  

The primary aim of this study is to demonstrate the feasibility of utilizing doxycycline to suppress matrix metalloproteinase-9 (MMP-9) in brain arteriovenous malformations (AVMs).     

Diagnostic difficulties in differentiating of arteriovenous fistula -- case report

Arteriovenous carotid-cavernous fistula is an abnormal connection between the dural branches of carotid artery or vertebral artery and the dural sinuses. Its clinical manifestations can resemble the crucial signs of thyroid orbitopathy, an inflammatory disorder of the orbit associated with Graves' disease. Therefore, differential diagnosis of thyroid orbitopathy and the congestion of the orbit seen in arteriovenous fistula is often clinically and radiologically confused. This is the case report of the simultaneous occurrence of dural arteriovenous fistula in 59 years old woman. The first manifestation was unilateral exophthalmia. After Computer Tomography and Magnetic Resonance Imaging were performed, the preliminary diagnosis of thyroid orbitopathy was established. The response of eye disorder to corticosteroid treatment resulted in evident deterioration. This prompted a reconsideration of the diagnosis and a new evaluation of the patient with sensitive techniques, leading to the final diagnosis of arteriovenous fistula.     

Chronic traumatic popliteal arteriovenous fistula: Case report

Chronic popliteal arteriovenous fistula is a common result of penetrating vascular trauma. Such a case, involving a young, active-duty soldier who received a gunshot wound to the back of his left leg, is reported. Operative findings confirmed the presence of a fistula and a dilated, tortuous popliteal vein. A 1-cm communication between the main popliteal vein and artery just above the knee was found. Division, with lateral venorrhaphy and end-to-end repair of the artery, was performed, with good results. Particularly stressed in this report is the importance of increased physician awareness, combined with an aggressive surgical approach to reduce the morbidity, especially the high amputation rate so often associated with this kind of penetrating vascular trauma.