دورية أكاديمية
Endovascular and percutaneous embolization of a giant post traumatic arteriovenous fistula of inferior epigastric vessels.
| العنوان: | Endovascular and percutaneous embolization of a giant post traumatic arteriovenous fistula of inferior epigastric vessels. |
|---|---|
| المؤلفون: | Arunachalam VS; Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India., Sharma S; Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. drsmilysharma@gmail.com., Valakkada J; Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India., Ayyappan A; Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India., Radhakrishnan J; Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India., Kannath SK; Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. |
| المصدر: | CVIR endovascular [CVIR Endovasc] 2024 May 06; Vol. 7 (1), pp. 43. Date of Electronic Publication: 2024 May 06. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Publishing Country of Publication: Switzerland NLM ID: 101738484 Publication Model: Electronic Cited Medium: Internet ISSN: 2520-8934 (Electronic) Linking ISSN: 25208934 NLM ISO Abbreviation: CVIR Endovasc Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: Cham : Springer International Publishing, [2018]- |
| مستخلص: | Background: Arteriovenous fistulas involving the anterior abdominal wall can result from trauma. Such fistulas may remain asymptomatic and undetected for a prolonged duration of time. They tend to recruit multiple arterial feeders with remodelling in the feeding arteries, making them challenging to treat. Case Presentation: We discuss a rare case of a 60-year-old male who presented with complaints of a progressive painless swelling in right lower abdomen. There was a history of blunt injury to abdomen at the same site during alleged road traffic accident 3 years ago. On CT angiography, an arteriovenous fistula was localised to the anterior abdominal wall arising predominantly from the right inferior epigastric artery with a giant venous sac and terminating as a tortuous single venous channel into the right external iliac vein. Few other small feeders were also seen arising from branches of right superior epigastric artery along Winslow's pathway. The main challenge in endovascular management of this patient was embolization of a high flow shunt with a large venous sac and multiple arterial feeders. The dominant arterial feeder was embolized using vascular plug. The superficial location of the lesion offered an additional percutaneous window besides endovascular approach. The venous sac was percutaneously accessed and embolized using n-butyl cyanoacrylate after balloon occlusion of outflow vein. On follow up ultrasonographic evaluation at 3 months, near complete thrombosis of the venous sac was achieved. Conclusions: Traumatic arteriovenous fistulas involving the inferior epigastric vessels are rare clinical entities. CT angiogram and digital subtraction angiography help in the optimal diagnosis and treatment planning. The use of mechanical embolization devices to cause flow arrest offers an opportunity to use liquid embolic agents which offer better percolation within the lesion. Interventional radiology offers an ideal management of these complex high flow fistulas with a good technical success and acceptable safety profile. (© 2024. The Author(s).) |
| References: | AJR Am J Roentgenol. 2007 Jun;188(6):W547-9. (PMID: 17515345) Sovrem Tekhnologii Med. 2021;12(4):55-61. (PMID: 34795993) Diagn Interv Imaging. 2014 Jan;95(1):85-6. (PMID: 24183597) Br J Surg. 1994 Sep;81(9):1296-9. (PMID: 7953391) Br J Radiol. 2003 Feb;76(902):135-6. (PMID: 12642284) Ann Vasc Surg. 1997 Jul;11(4):391-6. (PMID: 9236997) BMJ Case Rep. 2020 Apr 27;13(4):. (PMID: 32345586) J Vasc Surg. 2010 May;51(5):1265-7. (PMID: 20299180) J Vasc Surg. 2021 Mar;73(3):1087-1094.e8. (PMID: 33002586) |
| فهرسة مساهمة: | Keywords: Large venous sac; Percutaneous embolization; Post-traumatic arteriovenous fistula |
| تواريخ الأحداث: | Date Created: 20240506 Latest Revision: 20240509 |
| رمز التحديث: | 20240509 |
| مُعرف محوري في PubMed: | PMC11074072 |
| DOI: | 10.1186/s42155-024-00455-5 |
| PMID: | 38709345 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 2520-8934 |
|---|---|
| DOI: | 10.1186/s42155-024-00455-5 |