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Specific Arterial Disease
Published in Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos, McDonald's Blood Flow in Arteries, 2022
Creation of a proximal arteriovenous shunt in experimental animals has very little effect on the frequency-dependent components of ascending aortic impedance or on the contour of the aortic pressure wave, even though it may cause a considerable decrease in resistance and an increase in cardiac output (Mang, 1976). In humans, arteriovenous shunts are well tolerated by the heart, showing the extreme tolerance this organ possesses in dealing with a volume load, in contrast to a pressure load (see Chapter 12). Small arteriovenous shunts (as in atrial or even ventricular septal defect) do not require surgery, except when they pose a threat of a jet lesion and of infective endocarditis (in ventricular septal defect). Shunts are actually created artificially in the arm for convenient dialysis in patients with end-stage renal disease (Savage et al., 2002).
Cerebral Angiomas Presenting with Seizures
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
There remain a few patients with an underlying, angiographically defined cerebral AVM whose seizures are intractable to all forms of pharmacologic therapy. In such circumstances surgical treatment may have to be considered. It is important to bear in mind, however, that the seizures may be arising from cerebral tissue that is not necessarily adjacent to or intermixed with the cerebral AVM. The anomalous arteriovenous shunt that comprises the AVM may affect the cerebral circulation at some distance, leading to cerebral dysfunction at sites that are seemingly remote from the location of the nidus of the malformation. This needs to be considered when evaluating patients for corrective surgery, and in planning the operative procedure.
The Urinary System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Renal failure may necessitate dialysis, from the Greek words dia (across) and lysis (dissolution). Peritoneal dialysis (peritoneal lavage) uses the patient's own peritoneum as a semipermeable membrane to remove dissolved wastes. Hemodialysis, on the other hand, cycles the blood from an arteriovenous shunt or fistula to a synthetic membrane where it contacts the dialysate (dialysis solution) for removal of the wastes. Kidney transplant may be the necessary outcome.
Clinical and Pathological Features of Congenital Hepatic Hemangioma in Children: A Retrospective Analysis
Published in Fetal and Pediatric Pathology, 2023
Rong Wen, Zheng-Zhen Zhou, Wei-Jian Chen
Hepatic arteriovenous malformations (AMV) is an abnormal connection between arteries and veins. It typically manifests as an arteriovenous shunt and has some secondary vascular structural changes, such as arterialization of the vein wall and significant intimal changes. Capillary reactive hyperplasia is caused by tissue ischemia, but these blood vessels tend to be cleft-active, the lobule appearance is rougher than that of CH, the inflammatory response is obvious [4].
Effect of hyaluronidases added to different concentrations of bupivacaine on quality of ultrasound-guided supraclavicular brachial plexus block
Published in Egyptian Journal of Anaesthesia, 2021
Tarek Abdel Hay Mostafa, Alaa Mohammed Abo Hagar, Amany Faheem Abdel Salam Omara
The anesthesia for arteriovenous shunt creation varied between general anesthesia, regional anesthesia, and local infiltration. One of the most important advantages of regional anesthesia was sympathetic nerve which enhanced venous dilatation and increased blood flow, prevent thrombosis and fistula failure either intraoperatively or postoperatively. [17]
Successful treatment of ruptured extracranial carotid artery aneurysm and fistula associated with neurofibromatosis type1: Report of two cases
Published in Acta Oto-Laryngologica Case Reports, 2022
Ryutaro Onaga, Toru Sasaki, Tomohiko Yamauchi, Katsunari Namba, Ayuho Higaki, Akira Gomi, Hiroshi Nishino
A 55-year-old man with NF-1 presented at the emergency department of our hospital with the complaint of right-side swelling of the neck, neck pain with coughing and difficulty in breathing. Nasopharyngeal endoscopy showed complete pharyngeal obstruction and urgent cricothyroidotomy and tracheotomy were performed. On day 3, enhanced CT showed large hematomas at the bifurcation of the right common carotid artery, ICA and external carotid artery (ECA), measuring with total diameter of 100 × 90 mm, extending from the first to the fifth cervical vertebra (Figure 4(a,b)). Angiography showed two major high-flow arteriovenous fistulas (AVFs) in the right cervical area supplied by the main trunk of the right ICA and the internal maxillary artery, along with other small AVFs. The fistulas formed two venous pouches that converged into a common channel, subsequently draining into the right external jugular vein. Although no extravasation was detected on the angiogram, AVF rupture was diagnosed as the cause of the bleeding. On day 7, the patient developed massive bleeding in the right side of the neck accompanied by left hemiparesis. CT of the brain revealed acute cerebral infarction in the right middle cerebral artery area, presumably caused by compromised right ICA blood flow caused by the compressing hematoma and systemic hypotension. Urgent transarterial and transvenous embolization of the draining venous pouches and trapping of the affected and internal maxillary artery were performed using coils and NBCA. Embolization resulted in near-complete obliteration of the arteriovenous shunt and cessation of brisk bleeding. However, slowly developing hematoma and oozing continued, requiring attempted compression hemostasis and blood transfusion. Angiography on day 25 revealed a small residual AVF supplied by the right posterior auricular artery, which was embolized with NBCA, resulting in complete hemostasis and stabilization of the hematoma (Figure 5(a,b)). Although common carotid artery ligation was also considered, it was anatomically difficult to perform because of the hematoma. Subsequently, the patient developed a large infectious skin ulcer due to compression ischemia caused by the giant hematoma, which required long-term treatment with antibiotics.