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Arteriovenous fistula - A congenital or resulting from an injury anastomosis between Vienna and artery By which arterial blood It enters the venous system. Normally, the blood flow moves from the heart through the arteries to the capillary bed and then through the veins - back to the heart. In other words, when there is arteriovenous fistula direct connection vein artery. Fistulas are congenital and acquired .
Congenital arterial fistula may be located in any part of the body. Acquired fistula can be caused by damage to blood vessels during surgery, trauma, or because of the erosion of an aortic aneurysm with the advent of its connection with the oral cavity of the vein. These fistulas can be created artificially.
Acquired fistulae appear in trauma, such as stab wounds, operations, which resulted in the injured artery and adjacent Vienna. In most cases the fistula is formed immediately after the injury, and in the field of education fistula observed swelling due to the ingress of blood directly into soft tissue, bypassing the capillary bed.
It so happens that the arteriovenous fistula is created intentionally, for example, during treatment hemodialysis To avoid multiple puncture vessels. Usually in this case formed fistula in the forearm. Arteriovenous fistula, which will eventually increase in size, leading to a deterioration of blood supply to the area below the fistula, and due to increased heart ejection of blood to the heart is overloaded.
Symptoms of arteriovenous fistula
Symptoms arteriovenous fistulas depend on the volume of blood that enter the venous system and the location of the fistula. When congenital arteriovenous fistulas adjacent thereto tissue swell and become red. Especially not attractive it looks like in the case of a finding of fistula on his face.
Small fistulas usually occur without any symptoms. With a large volume of blood flowing in the veins may experience slow Blood Pressure Increase pulse pressure , Increase in heart rate ( tachycardia ), Which leads to overloading of the heart. In this case, urgent treatment is necessary arteriovenous fistula operational methods.
In the fistula usually occurs edema, varicose veins and pulsation, increased skin temperature, but the temperature is lowered below the fistula. In parts of the limbs below the fistula can be observed trophic disorders.
Complications of arteriovenous fistula is not rarely lead to the fact that it is becoming a hotbed of bacterial infection And large fistula lead to the development of varicose veins of the legs, as well as heart failure.
Diagnosis of arteriovenous fistula
The diagnosis is a doctor on the basis of examination of the patient, and laboratory results. If you are not a deep location of the fistula, it can be palpate as a mass lesion, with pulsating veins. On the proposed location arteriovenous fistula doctor listens to the noise using stethoscope .
It helps to confirm the diagnosis an ultrasound duplex scanning ( Doppler ), And in the case of deep-lying fistulas held angiography . Also it carried out computer tomography and magnetic resonance angiography is less invasive, but less informative.
Diagnosis of arteriovenous fistula by angiography is a visualization of the vessels when administered Contrast under the influence of X-rays, and allows to identify the precise location of the fistula, as well as its resolution.
Treatment of arteriovenous fistula
Congenital fistula of small size can be removed by a method laser coagulation . This operation carries a vascular surgeon. Similar operations are particularly dangerous if the arteriovenous fistula is located near the brain, eyes or other vital organs.
Acquired arteriovenous fistula treated urgently. For surgery, angiography, and then the decision about treatments. Arteriovenous fistula can be removed by endovascular When exposed to X-rays is injected into a vessel certain substance that covers the direct connection between an artery and a vein. In more complex cases, the surgery is performed.
Treatment occurred during arteriovenous fistula complications conducted according to general rules.
Complications of arteriovenous fistula
The most common complications of arteriovenous fistula complicating symptoms manifesting reinforced cosmetic defects - In the form of a reddish, sometimes purple, skin around the fistula, which looks not very aesthetically pleasing. If arterial fistula is not treated, it can lead to the emergence and development Aneurysm , Varicose veins, as well as thrombosis .
Arteriovenous fistula is accompanied by the fact that large amounts of blood from the artery under strong pressure falls into the vein. However vein wall weaker than that of the artery and blood flow Vienna expands, leading to damage to its walls. Because the pressure in the artery decreases and increases in the vein, blood flow to certain areas, where the affected blood vessels are located, is reduced.
Another complication is the development of arteriovenous fistula in patients with heart failure due to a decrease in blood pressure and increase heart rate.
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