Arteriovenous fistula

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

Overview

An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathologic process, such as trauma or erosion of an arterial aneurysm. These communications can occur at any point in the vascular system; varying in size, length, location, and number.

Historical Perspective

  • Arteriovenous fistula (AVF) was first discovered by William Hunter, in 1758, during a venupuncture with accidental piercing of the artery.[1][2][3][4]
  • Congenital arteriovenous fistula (AVF) of the coronary arteries, a rare cardiac anomaly, was first described by Krause W. Uber, in 1865.[5][6][7]

Classification

  • Arteriovenous fistula (AVF) can be classified into:
  • Congenital, a developmental anomaly in which there are always multiple fistulas between the arteries and veins[8][3]
  • Acquired, usually a single communication, which can be the result of an injury or can be a part of treatment for the purpose of hemodialysis.[3][9][10][11]

Pathophysiology

  • The abnormal communication causes shunting of blood from high-pressure arterial side to the low-pressure venous side.
  • An arteriovenous fistula (AVF) involving a major artery such as the abdominal aorta can lead to a large decrease in peripheral resistance, which in turn causes the heart to increase cardiac output in order to maintain proper blood flow to all tissues.
  • The physical manifestations of this would be a relatively normal systolic blood pressure with a decreased diastolic blood pressure resulting in a wide (large) pulse pressure.
  • Large arteriovenous fistulae (AVF) can lead to congestive heart failure associated with increased activity of vasoconstrictor neurohormonal systems, renin-angiotensin, sympathetic nervous system, endothelin system, and Arginine vasopressin.[12]
  • The increased activity of vasoconstrictor neurohormonal systems is in concurrence with compensatory activation of systemic and vasodilating systems, atrial natriuretic peptide (ANP) and nitric oxide (NO).
  • A fistula can progress to an aneurysm, usually in the setting of a trauma, carrying a risk of rupture and necessitating surgical intervention.[13]
  • The malformation can result in hemorrhage and the risk is significantly higher with small size malformation because of the significantly higher feeding artery pressures.[14]

Clinical Features

  • In the case of coronary arteriovenous fistula (AVF) patients can be asymptomatic or can present with:
  • Continuous murmur
  • Cardiomegaly
  • Chest pain
  • Fatigue
  • Palpitation
  • Angina
  • Bacterial endocarditis[15][16]
  • Systemic hypotension[17]
  • Fistulae involving the spinal vasculature can present with neurologic symptoms of the lower extremities which may include weakness and sensory disturbance.[18]
  • Acquired arteriovenous fistula (AVF) can result in digital clubbing.[19]
  • Patients on hemodialysis with arteriovenous fistula (AVF) can develop pseudo-Kaposi's sarcoma.[20]
  • Abdominal arteriovenous fistulae can present with:
  • Lower extremity edema with cyanosis
  • Pulsatile varicose veins
  • Scrotal edema[21]
  • Ilio-iliac arteriovenous fistula (AVF) presents with progressive abdominal distention, dyspnea, and swollen leg, which makes it difficult to distinguish from deep venous thrombosis (DVT) and can lead to a delay in the diagnosis.[22]
  • Tentorial dural arteriovenous fistula (AVF) can rarely manifest as trigeminal neuralgia.[23]

Differentiating Arteriovenous Fistula (AVF) from other Conditions

  • It is important to differentiate an arteriovenous fistula (AVF) from other conditions that cause a hyperdynamic circulation such as:
  • Cirhhosis[24]
  • Graves' ophthalmopathy[25]
  • Various sarcomas such as, angiosarcoma and leiomyosarcoma.[26][27]
  • Paget's disease of bone[28][29]
  • An ilio-iliac arteriovenous fistula (AVF) can lead to a misdiagnosis of deep venous thrombosis (DVT)[22]

Epidemiology and Demographics

  • In a Scottish population-based study, the incidence of dural arteriovenous fistulae in adults was 0.16 per 100 000 per year.[30][31]
  • In an Olmsted County, Minnesota-based study, the incidence and prevalence of dural arteriovenous fistulae from 1965-1992 are as follows:
  • From 1965-1992, the incidence was estimated to be 1.84 cases per 100,000 individuals.
  • From 1985-1992, the incidence was estimated to be 2.75 cases per 100,000 individuals.
  • On january 1, 1990, the prevalance of identified cases was 19.0 per 100,000 individuals.[32]

Age

  • Individuals of all age groups may acquire the condition.
  • Congenital type of arteriovenous fistula (AVF) is present at birth and may manifest early or later in life.

Gender

  • Arteriovenous fistula (AVF) is observed in both men and women equally.

Race

  • There is no racial predilection for arteriovenous fistula (AVF).

Risk Factors

  • Common risk factors for the development of an arteriovenous fistula (AVF):

Natural History, Complications and Prognosis

  • Patients can remain asymptomatic or can present with symptoms depending on the involved vasculature.
  • Early clinical features include hypotension with hypoperfusion, skin changes, and can progress to include cardiac manifestations.
  • If left untreated, a large arteriovenous fistula can lead to compensated/decompensated heart failure.[49][50][51][52][53]
  • Complications of arteriovenous fistula (AVF) include:
  • Prognosis of arteriovenous fistulae is dependent on the system involved with many congenital fistulae undergoing regression and large fistulae may progress to cardiac decompensation and death.

Diagnosis

Diagnostic Criteria

  • An arteriovenous fistula (AVF) can be detected by a stethoscope and can present with a machinery murmur.[120][121][18][122]
  • A more superficial fistula can also be detected by palpation, presenting as continuous vibration.[123]
  • Imaging is the modality of choice to effectively diagnose an arteriovenous fistula (AVF) and it includes:

Symptoms

  • An arteriovenous fistula (AVF) can be asymptomatic.
  • Symptoms may include:

Physical Examination

  • Patients with an arteriovenous fistula (AVF) usually appear normal.
  • Physical examination may be remarkable for:

Laboratory Findings

  • Laboratory findings associated with an arteriovenous fistula (AVF) can include the following:
  • Polycythemia[147]
  • Decreased arterial PO2
  • Decreased oxygen saturation[153]
  • Increased venous oxygen content[154]
  • Decreased platelets and fibrinogen in the case of large fistulae[155]
  • Swan-Ganz catheter findings in pulmonary arteriovenous fistula (AVF) include decreased arterial oxygenation and shunting of cardiac output.[156]
  • Swan-Ganz catheter findings in aorto-caval fistula include higher vena caval pressure and higher than normal oxygen content.[154]
  • Patients on hemodialysis suffering from occlusive and thrombotic events of the arteriovenous fistula (AVF) may exhibit significant increase of platelet surface glycoproteins GPIb and GPIIb/IIIa.[157]
  • Large fistulae can also present with laboratory findings of consumptive coagulopathy such as, low platelets, increased bleeding time, elevated prothrombin time (PT) and partial thromboplastin time (PTT), and signs of enhanced fibrinolysis.[155][158]

Imaging Findings

  • Computed tomography angiography (CTA) and magnetic resonance angiogrpahy (MRA) are the imaging modalities of choice for arteriovenous fistula (AVF) with modest evidence that computed tomography angiography (CTA) is better than magnetic resonance (MR) angiogrpahy.[129]
  • On plain radiograph, an arteriovenous fistula (AVF) is characterized by a round or oval lobulated homogeneous mass and the identification of feeding and draining vessels can also be be possible.[159]
  • On ultrasound, an arteriovenous fistula (AVF) is characterized by a pseudoaneurysm, high flow velocity, increased diastolic arterial flow, abnormal arterial pulsitility in the vein, and enlargement of the downstream vein.[160][161][162][163]
  • On computed tomography angiogrphy (CTA) and magnetic resonance angiography (MRA), an arteriovenous fistula is characterized by abnormal dilatation along with early and flow-related enhancements.[164][129]
  • On digital subtraction arteriography (DSA), an arteriovenous fistula (AVF) is characterized by abnormal early filling of an adjacent vein in the region of the fistula.[165]

Other Diagnostic Studies

  • An arteriovenous fistula (AVF) involving the heart and pulmonary vasculature in some cases, can also be diagnosed via echocardiography.[166][167][168]
  • Findings on echocardiography may include, dilated lumen and abnormal unidirectional continuous flow signals with broad velocity spectra[168]
  • An aorto-caval fistula may also be diagnosed using Swan-Ganz catheter, demonstrating higher vena caval pressure and higher than normal oxygen content.

Treatment

Medical Therapy

  • There is no medical treatment for an arteriovenous fistula (AVF).
  • Iatrogenic arteriovenous fistulae, presenting only as pain, can resolve after a trial of compression and observation.[169][169]
  • Asymptomatic fistulae can resolve spontaneously and most lesions can be monitored after detection especially if the size of the lesion is small and they do not cause adverse effects.[170]
  • Conservative management has been tried with a successful outcome in the case of an arteriovenous fistula (AVF) as a complication of vascular catheterization.[169]

Surgery

  • Surgery is the mainstay of therapy for an arteriovenous fistula (AVF).
  • Endovascular embolization is the most common approach to the treatment of an arteriovenous fistula (AVF), where a catheter is inserted into an artery and, guided by fluoroscopic or x-ray imaging, contrast is injected to visualize the vasculature followed by the injection of an embolization material (such as, particles, liquid embolics, embolization glue, detachable balloons, vascular plugs, and coils) into the exact location where the artery and the vein meet.[171][172][173][174][175][176][177]
  • Microsurgery, with or without endovascular embolization, is the most appropriate treatment for dural, brain, or spinal arteriovenous fistulae, where a titanium clip is placed to cut off the connection between the artery and the vein.[175][178][179][180]
  • Stereotactic radiosurgery, the treatment of choice to successfully obliterate an arteriovenous fistula (AVF) with low complication rates and hence preferred over endovascular embolization and microsurgery in the case of an arteriovenous fistula close to important brain structures.[181][180][182][183][184]
  • Open surgical repair[185][186][187][188][136][189]

Prevention

  • There are no specific primary prevention measures available for an arteriovenous fistula.
  • The acquired type, caused by trauma, can be prevented by avoiding trauma and also using caution while performing vascular access procedures.

Doppler Echocardiography

(Images shown below are courtesy of RadsWiki)

  • Renal arteriovenous fistula
    Renal arteriovenous fistula
  • Renal arteriovenous fistula
    Renal arteriovenous fistula
  • Renal arteriovenous fistula
    Renal arteriovenous fistula

2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)

Coronary Arteriovenous Fistula (DO NOT EDIT)[190]

Class I
"1. If a continuous murmur is present, its origin should be defined either by echocardiography, MRI, CT angiography, or cardiac catheterization. (Level of Evidence: C)"
”2. A large coronary arteriovenous fistula (CAVF), regardless of symptomatology, should be closed via either a transcatheter or surgical route after delineation of its course and its potential to fully obliterate the fistula. (Level of Evidence: C)"
”3. A small to moderate CAVF in the presence of documented myocardial ischemia, arrhythmia, otherwise unexplained ventricular systolic or diastolic dysfunction or enlargement, or endarteritis should be closed via either a transcatheter or surgical approach after delineation of its course and its potential to fully obliterate the fistula. (Level of Evidence: C)"
Class III
"1. Patients with small, asymptomatic CAVF should not undergo closure of CAVF. (Level of Evidence: C)"
Class IIa
"1. Clinical follow-up with echocardiography every 3 to 5 years can be useful for patients with small, asymptomatic CAVF to exclude development of symptoms or arrhythmias or progression of size or chamber enlargement that might alter management. (Level of Evidence: C)"

Management Strategies for CAVF(DO NOT EDIT)[190]

Class I
"1. Surgeons with training and expertise in CHD should perform operations for management of patients with CAVF. (Level of Evidence: C)"
”2. Transcatheter closure of CAVF should be performed only in centers with expertise in such procedures. (Level of Evidence: C)"
”3. Transcatheter delineation of CAVF course and access to distal drainage should be performed in all patients with audible continuous murmur and recognition of CAVF. (Level of Evidence: C)"

References

  1. ↑ Khodadad G (January 1973). "Arteriovenous malformations of the scalp". Ann. Surg. 177 (1): 79–85. PMC 1355509. PMID 4682507.
  2. ↑ Liu J, Shimada Y (2014). "A Case of Intractable Left Forearm Congenital Arteriovenous Fistula Ending with Amputation: Importance of New Medical Information Obtained via the Internet". J Rural Med. 9 (1): 37–9. doi:10.2185/jrm.2878. PMC 4310049. PMID 25650050.
  3. ↑ 3.0 3.1 3.2 Yater WM (January 1928). "ACQUIRED ARTERIOVENOUS FISTULA". Ann. Surg. 87 (1): 19–31. PMC 1398373. PMID 17865813.
  4. ↑ Olivecrona, Herbert (1957). Congenital arteriovenous aneurysms of the carotid and vertebral arterial systems. Berlin: Springer. ISBN 9783540022046.
  5. ↑ Albeyoglu S, Aldag M, Ciloglu U, Sargin M, Oz TK, Kutlu H, Dagsali S (2017). "Coronary Arteriovenous Fistulas in Adult Patients: Surgical Management and Outcomes". Braz J Cardiovasc Surg. 32 (1): 15–21. doi:10.21470/1678-9741-2017-0005. PMC 5382904. PMID 28423125.
  6. ↑ Lim WH, Kang SH, Jeon K, Cho I, Kim KH, Hwang SW, Kim HK, Sohn DW (September 2009). "Asymptomatic Right Coronary Artery-to-Pulmonary Artery Fistula Incidentally Detected by Transthoracic Echocardiography". J Cardiovasc Ultrasound. 17 (3): 106–9. doi:10.4250/jcu.2009.17.3.106. PMC 2889379. PMID 20661326.
  7. ↑ Jang SN, Her SH, Do KR, Kim JS, Yoon HJ, Lee JM, Jin SW (December 2008). "A case of congenital bilateral coronary-to-right ventricle fistula coexisting with variant angina". Korean J. Intern. Med. 23 (4): 216–8. doi:10.3904/kjim.2008.23.4.216. PMC 2687685. PMID 19119260.
  8. ↑ Luke JC (April 1940). "CONGENITAL ARTERIOVENOUS FISTULA". Can Med Assoc J. 42 (4): 341–5. PMC 537854. PMID 20321666.
  9. ↑ Robbs JV, Carrim AA, Kadwa AM, Mars M (September 1994). "Traumatic arteriovenous fistula: experience with 202 patients". Br J Surg. 81 (9): 1296–9. PMID 7953391.
  10. ↑ Nagpal K, Ahmed K, Cuschieri R (2008). "Diagnosis and management of acute traumatic arteriovenous fistula". Int. J. Angiol. 17 (4): 214–6. PMC 2728918. PMID 22477453.
  11. ↑ Laberge JM (December 2004). "Interventional management of renal transplant arteriovenous fistula". Semin Intervent Radiol. 21 (4): 239–46. doi:10.1055/s-2004-861558. PMC 3036239. PMID 21331135.
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  13. ↑ 13.0 13.1 13.2 Soumer K, Benomrane S, Derbel B, Laribi J, Benmrad M, Elleuch N, Kalfat T, Khayati A (February 2015). "Popliteal pseudoaneurysm and arteriovenous fistula after acupuncture". J Mal Vasc. 40 (1): 58–62. doi:10.1016/j.jmv.2014.11.001. PMID 25623503.
  14. ↑ Spetzler RF, Hargraves RW, McCormick PW, Zabramski JM, Flom RA, Zimmerman RS (June 1992). "Relationship of perfusion pressure and size to risk of hemorrhage from arteriovenous malformations". J. Neurosurg. 76 (6): 918–23. doi:10.3171/jns.1992.76.6.0918. PMID 1588424.
  15. ↑ Zamani H, Meragi M, Arabi Moghadam MY, Alizadeh B, Babazadeh K, Mokhtari-Esbuie F (2015). "Clinical presentation of coronary arteriovenous fistula according to age and anatomic orientation". Caspian J Intern Med. 6 (2): 108–12. PMC 4478461. PMID 26221510.
  16. ↑ Sapin P, Frantz E, Jain A, Nichols TC, Dehmer GJ (March 1990). "Coronary artery fistula: an abnormality affecting all age groups". Medicine (Baltimore). 69 (2): 101–13. PMID 2319939.
  17. ↑ 17.0 17.1 Mise N, Uchida L, Tanaka M, Tanaka S, Nakajima H, Sugimoto T (October 2011). "Acute systemic hypotension after arteriovenous fistula construction in a patient with severe aortic stenosis". Clin. Exp. Nephrol. 15 (5): 788–790. doi:10.1007/s10157-011-0484-3. PMID 21725657.
  18. ↑ 18.0 18.1 18.2 Asada D, Itoi T, Hamaoka K (December 2015). "Asymptomatic spinal arteriovenous fistula presenting only as continuous murmur". Pediatr Int. 57 (6): 1208–10. doi:10.1111/ped.12716. PMID 26711922.
  19. ↑ Leb DE, Sharma JK (July 1978). "Clubbing secondary to an arteriovenous fistula used for hemodialysis". JAMA. 240 (2): 142–3. PMID 660832.
  20. ↑ 20.0 20.1 Hwang SM, Lee SH, Ahn SK (December 1999). "Pincer nail deformity and pseudo-Kaposi's sarcoma: complications of an artificial arteriovenous fistula for haemodialysis". Br. J. Dermatol. 141 (6): 1129–32. PMID 10606867.
  21. ↑ Scruggs J, Bennett DD (June 2011). "Cutaneous manifestations of abdominal arteriovenous fistulas". Cutis. 87 (6): 284–6. PMID 21838084.
  22. ↑ 22.0 22.1 Li Y, Fu Q, Liu A, Zheng Z, Fan W, Zhu Z, Chen L, Dai W (November 2014). "[A case of iatrogenic ilio-iliac arteriovenous fistula initially misdiagnosed as deep venous thrombosis]". Zhong Nan Da Xue Xue Bao Yi Xue Ban (in Chinese). 39 (11): 1217–20. doi:10.11817/j.issn.1672-7347.2014.11.019. PMID 25432380.
  23. ↑ Lu X, Qin X, Ni L, Chen J, Xu F (November 2013). "Tentorial dural arteriovenous fistula manifesting as contralateral trigeminal neuralgia: resolution after transarterial Onyx embolization". BMJ Case Rep. 2013. doi:10.1136/bcr-2013-010984. PMC 3847479. PMID 24285803.
  24. ↑ Fernández-Rodriguez CM, Prieto J, Zozaya JM, Quiroga J, Guitián R (April 1993). "Arteriovenous shunting, hemodynamic changes, and renal sodium retention in liver cirrhosis". Gastroenterology. 104 (4): 1139–45. PMID 8462804.
  25. ↑ Celik O, Buyuktas D, Islak C, Sarici AM, Gundogdu AS (July 2013). "The association of carotid cavernous fistula with Graves' ophthalmopathy". Indian J Ophthalmol. 61 (7): 349–51. doi:10.4103/0301-4738.109533. PMC 3759106. PMID 23571267.
  26. ↑ 26.0 26.1 Oskrochi Y, Razi K, Stebbing J, Crane J (January 2016). "Angiosarcoma and Dialysis-related Arteriovenous Fistulae: A Comprehensive Review". Eur J Vasc Endovasc Surg. 51 (1): 127–33. doi:10.1016/j.ejvs.2015.08.016. PMID 26482509.
  27. ↑ 27.0 27.1 Weinreb W, Steinfeld A, Rodil J, Esparza A, Trebbin W (July 1983). "Leiomyosarcoma arising in an arteriovenous fistula". Cancer. 52 (2): 390–2. PMID 6861080.
  28. ↑ Putschar WG (October 1972). "Circulation in Paget's disease of bone". N. Engl. J. Med. 287 (14): 717–8. doi:10.1056/NEJM197210052871410. PMID 5055421.
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  30. ↑ Elhammady MS, Ambekar S, Heros RC (2017). "Epidemiology, clinical presentation, diagnostic evaluation, and prognosis of cerebral dural arteriovenous fistulas". Handb Clin Neurol. 143: 99–105. doi:10.1016/B978-0-444-63640-9.00009-6. PMID 28552162.
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  32. ↑ Brown RD, Wiebers DO, Torner JC, O'Fallon WM (April 1996). "Incidence and prevalence of intracranial vascular malformations in Olmsted County, Minnesota, 1965 to 1992". Neurology. 46 (4): 949–52. PMID 8780070.
  33. ↑ Altin RS, Flicker S, Naidech HJ (March 1989). "Pseudoaneurysm and arteriovenous fistula after femoral artery catheterization: association with low femoral punctures". AJR Am J Roentgenol. 152 (3): 629–31. doi:10.2214/ajr.152.3.629. PMID 2783816.
  34. ↑ Sugahara T, Azuma M, Nakashima K, Ito K, Suzuki R, Hagio K, Uetani H, Yanaga Y, Baba Y (July 2013). "Postcatheterization radial arteriovenous fistula: balloon-assisted direct percutaneous embolization with N-butyl cyanoacrylate and 50 % glucose solution in two sessions". Jpn J Radiol. 31 (7): 505–10. doi:10.1007/s11604-013-0206-8. PMID 23609100.
  35. ↑ Perings SM, Kelm M, Jax T, Strauer BE (April 2003). "A prospective study on incidence and risk factors of arteriovenous fistulae following transfemoral cardiac catheterization". Int. J. Cardiol. 88 (2–3): 223–8. PMID 12714202.
  36. ↑ Kron J, Sutherland D, Rosch J, Morton MJ, McAnulty JH (May 1985). "Arteriovenous fistula: a rare complication of arterial puncture for cardiac catheterization". Am. J. Cardiol. 55 (11): 1445–6. PMID 3993595.
  37. ↑ Glaser RL, McKellar D, Scher KS (November 1989). "Arteriovenous fistulas after cardiac catheterization". Arch Surg. 124 (11): 1313–5. PMID 2818187.
  38. ↑ Sidawy AN, Neville RF, Adib H, Curry KM (April 1993). "Femoral arteriovenous fistula following cardiac catheterization: an anatomic explanation". Cardiovasc Surg. 1 (2): 134–7. PMID 8076015.
  39. ↑ Kim D, Orron DE, Skillman JJ, Kent KC, Porter DH, Schlam BW, Carrozza J, Reis GJ, Baim DS (February 1992). "Role of superficial femoral artery puncture in the development of pseudoaneurysm and arteriovenous fistula complicating percutaneous transfemoral cardiac catheterization". Cathet Cardiovasc Diagn. 25 (2): 91–7. PMID 1544161.
  40. ↑ Groth KA, Erik Nielsen-Kudsk J, Nørgaard BL, Andersen NH (August 2013). "Internal mammary arteriovenous fistula found late after aortic root replacement". Eur Heart J Cardiovasc Imaging. 14 (8): 831. doi:10.1093/ehjci/jet025. PMID 23847386.
  41. ↑ Kawano Y, Tamura A, Kadota J (June 2007). "An unusual femoral arteriovenous fistula following cardiac catheterization". Int. J. Cardiol. 119 (1): e17–8. doi:10.1016/j.ijcard.2007.01.080. PMID 17449120.
  42. ↑ Nagata T, Johno H (December 2017). "Radial arteriovenous fistula following coronary angiography". J Card Surg. 32 (12): 805–806. doi:10.1111/jocs.13257. PMID 29235152.
  43. ↑ Melo NC, Mundim JS, Costalonga EC, Lucon AM, Santello JL, Praxedes JN (May 2009). "Three cases of hypertension and renal arteriovenous fistula with a de novo fistula". Arq. Bras. Cardiol. 92 (5): e36–8, e63–5. PMID 19629281.
  44. ↑ McAlhany JC, Black HC, Hanback LD, Yarbrough DR (July 1971). "Renal arteriovenous fistula as a cause of hypertension". Am. J. Surg. 122 (1): 117–20. PMID 5091842.
  45. ↑ Goldberg A, Tsipis A, Rosenfeld I (June 2013). "Arteriovenous fistula after cardiac catheterization from a radial approach". Isr. Med. Assoc. J. 15 (6): 313–4. PMID 23882900.
  46. ↑ Doblas, M.; Cuesta, M. A.; Garcia, L. Garcia; Diaz, E. Garcia; Bengoechea, E. (2016). "Distal Venous Hypertension in Side-to-Side Arteriovenous Fistulae". Phlebology: The Journal of Venous Disease. 3 (2): 135–138. doi:10.1177/026835558800300211. ISSN 0268-3555.
  47. ↑ 47.0 47.1 Jonasson SA, Jøssang DE, Haaverstad R, Wendelbo Ø, Pedersen G (February 2016). "Arteriovenous fistula of the groin in a drug abuser with endocarditis". J Surg Case Rep. 2016 (2). doi:10.1093/jscr/rjw001. PMC 5654361. PMID 26829963.
  48. ↑ Gabow P, de Torrente A, Holt S, Kelly GL (May 1976). "Arteriovenous fistula from drug abuse. Implications for hemodialysis". JAMA. 235 (20): 2220–1. PMID 946848.
  49. ↑ Du Toit DF, Van der Merwe DM, Groenewald JH, De Roubaix JA (February 1983). "High-output cardiac failure associated with an iliac artery aneurysm and arteriovenous fistula. A case report". S. Afr. Med. J. 63 (8): 293–4. PMID 6823650.
  50. ↑ Rehman S, Sinclair H, Rodway A, Kovalic A, Webb-Peploe K, Yusuf SW (November 2017). "Same features, different diagnosis: A case of ilio-iliac arteriovenous fistula presenting as decompensated heart failure". JRSM Open. 8 (11): 2054270417739778. doi:10.1177/2054270417739778. PMC 5682584. PMID 29163978.
  51. ↑ Stern AB, Klemmer PJ (January 2011). "High-output heart failure secondary to arteriovenous fistula". Hemodial Int. 15 (1): 104–7. doi:10.1111/j.1542-4758.2010.00518.x. PMID 21223485.
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  134. ↑ 134.0 134.1 Kamyar MM, Saeed Modaghegh MH, Kazemzadeh G (December 2016). "Limb complaints after autogenous arteriovenous fistula creation in chronic hemodialysis patients". Semin Vasc Surg. 29 (4): 172–177. doi:10.1053/j.semvascsurg.2016.11.002. PMID 28779783.
  135. ↑ 135.0 135.1 135.2 Huang W, Villavicencio JL, Rich NM (April 2005). "Delayed treatment and late complications of a traumatic arteriovenous fistula". J. Vasc. Surg. 41 (4): 715–7. doi:10.1016/j.jvs.2005.01.049. PMID 15874939.
  136. ↑ 136.0 136.1 Takahashi S, Katayama K, Tatsugawa T, Sueda T (January 2015). "A successful hybrid repair for vertebral arteriovenous fistula with extracranial vertebral artery aneurysm". Ann Vasc Surg. 29 (1): 126.e5–8. doi:10.1016/j.avsg.2014.07.038. PMID 25304908.
  137. ↑ Opanasenko MS, Klymenko VI, Demus RS, Konik BM, Tereshkovych OV, Kalenychenko MI, Bychkovs'kyĭ VB, Obrems'ka OK, Levanda LI, Kononenko VA, Kshanovs'kyĭ OE, Mykytenko I (November 2013). "[Pulmonary arteriovenous fistulas]". Klin Khir (in Ukrainian) (11): 41–6. PMID 24501988. Vancouver style error: initials (help)
  138. ↑ Ozeki S, Utsunomiya T, Kishi T, Tokushima T, Tsuji S, Matsuo S, Natsuaki M, Ito T, Yano K (August 2002). "Coronary arteriovenous fistula presenting as chronic pericardial effusion". Circ. J. 66 (8): 779–82. PMID 12197607.
  139. ↑ Porter J, Al-Jarrah Q, Richardson S (2014). "A case of femoral arteriovenous fistula causing high-output cardiac failure, originally misdiagnosed as chronic fatigue syndrome". Case Rep Vasc Med. 2014: 510429. doi:10.1155/2014/510429. PMC 4055063. PMID 24959370.
  140. ↑ 140.0 140.1 Fourcade L, Vahdat B, Panagides D, Yvorra S, Bonnet JL, Bory M (January 1996). "[Pulmonary arteriovenous fistula. A rare cause of dyspnea and cyanosis in an adult]". Arch Mal Coeur Vaiss (in French). 89 (1): 103–6. PMID 8678732.
  141. ↑ Roberts H, Curnow PA (February 2007). "Unilateral limited scleroderma-like changes following formation of an arteriovenous fistula". Australas. J. Dermatol. 48 (1): 37–9. doi:10.1111/j.1440-0960.2007.00325.x. PMID 17222301.
  142. ↑ Chen B, Tang CW, Zhang CL, Cao JW, Wei B, Li X (April 2012). "Melena-associated regional portal hypertension caused by splenic arteriovenous fistula". World J. Gastroenterol. 18 (16): 1996–8. doi:10.3748/wjg.v18.i16.1996. PMC 3337579. PMID 22563184.
  143. ↑ Dokumcu Z, Ozcan C, Alper H, Erdener A (August 2015). "Pulmonary arteriovenous malformation in children". Pediatr Int. 57 (4): 708–11. doi:10.1111/ped.12564. PMID 25712408.
  144. ↑ Majeed FA, Ghumman AQ, Chatha SS (2013). "Pulmonary arteriovenous malformation (PAVM): rare cause of hemoptysis". J Ayub Med Coll Abbottabad. 25 (3–4): 100–2. PMID 25226754.
  145. ↑ Hu Y, Zhong Q, Li Z, Chen J, Shen C, Song Y (February 2013). "An occult congenital fistula between the descending aorta and the left pulmonary vein in an adult presenting with recurrent episodes of hemoptysis". Chest. 143 (2): 549–553. doi:10.1378/chest.11-3229. PMID 23381321.
  146. ↑ 146.0 146.1 146.2 146.3 Parks AH, Guy BL, Rawlings CA, Constantino MJ (February 1989). "Lameness in a mare with signs of arteriovenous fistula". J. Am. Vet. Med. Assoc. 194 (3): 379–80. PMID 2917907.
  147. ↑ 147.0 147.1 147.2 147.3 Swanson KL, Prakash UB, Stanson AW, Ketteridge D, Brezina R, Schramek S, Kazár J, Moroff G, Brandt KG, Anderson TR, Slotkin TA, Harrison LW, Auld DS, Vallee BL, Baghurst PA, Nichol LW, Kozuch O, Mayer V, Swanson KL, Prakash UB, Stanson AW, Schmoldt A, Benthe HF, Haberland G, Lambros C, Bacchi CJ, Moroff G, Brandt KG, Anderson TR, Slotkin TA, Harrison LW, Auld DS, Vallee BL (July 1999). "Pulmonary arteriovenous fistulas: Mayo Clinic experience, 1982-1997". Mayo Clin. Proc. 74 (7): 671–80. doi:10.4065/74.7.671. PMID 10405695.
  148. ↑ BURCHELL HB (July 1958). "Observations on bradycardia produced by occlusion of an artery proximal to an arteriovenous fistula (Nicoladoni-Branham sign)". Med. Clin. North Am. 42 (4): 1029–35. PMID 13564989.
  149. ↑ Dallo L, Pastrana C, Rodríguez G, Medina Mora O, Barragán R, Bialostozky D (1984). "[Acquired systemic arteriovenous fistulas. Experience of 33 cases]". Arch Inst Cardiol Mex (in Spanish; Castilian). 54 (2): 159–66. PMID 6742939.
  150. ↑ Iwamuro Y, Nakahara I, Higashi T, Iwaasa M, Watanabe Y, Hirata E, Tsunetoshi K, Taha M (May 2006). "Tentorial dural arteriovenous fistula presenting symptoms due to mass effect on the dilated draining vein: case report". Surg Neurol. 65 (5): 511–5. doi:10.1016/j.surneu.2005.07.076. PMID 16630920.
  151. ↑ Ernst GL, Carlson AP (November 2016). "Transverse Sinus Dural Arteriovenous Fistula Presenting with Acute Hydrocephalus from Cerebellar Venous Engorgement Resolving with Endovascular Treatment". J Neurol Surg A Cent Eur Neurosurg. 77 (6): 538–542. doi:10.1055/s-0035-1563558. PMID 26444959.
  152. ↑ Nasr DM, Brinjikji W, Clarke MJ, Lanzino G (May 2017). "Clinical presentation and treatment outcomes of spinal epidural arteriovenous fistulas". J Neurosurg Spine. 26 (5): 613–620. doi:10.3171/2016.9.SPINE16618. PMID 28186472.
  153. ↑ Modaghegh MH, Roudsari B, Hafezi S (July 2015). "Digital pressure and oxygen saturation measurements in the diagnosis of chronic hemodialysis access-induced distal ischemia". J. Vasc. Surg. 62 (1): 135–42. doi:10.1016/j.jvs.2015.02.024. PMID 25827966.
  154. ↑ 154.0 154.1 Kwaan JH, McCart PM, Jones SA, Connolly JE (June 1977). "Aortocaval fistula detection using a Swan-Ganz catheter". Surg Gynecol Obstet. 144 (6): 919–21. PMID 871003.
  155. ↑ 155.0 155.1 Rhodes GR, Cox CB, Silver D (April 1973). "Arteriovenous fistula and false aneurysm as the cause of consumption coagulopathy". Surgery. 73 (4): 535–40. PMID 4690101.
  156. ↑ Harrow EM, Beach PM, Wise JR, Lynch C, Graham WG, Wight G (January 1978). "Pulmonary arteriovenous fistula. Preoperative evaluation with a Swan-Ganz catheter". Chest. 73 (1): 92–4. PMID 620567.
  157. ↑ Liani M, Salvati F, Tresca E, Di Paolo G, Vitacolonna L, Golato M, Velussi C (August 1996). "Arteriovenous fistula obstruction and expression of platelet receptors for von Willebrand factor and for fibrinogen (glycoproteins GPib and GPiib/iiia) in hemodialysis patients". Int J Artif Organs. 19 (8): 451–4. PMID 8841843.
  158. ↑ Erdem Y, Haznedaroglu IC, Celik I, Yalcin AU, Yasavul U, Turgan C, Caglar S (July 1996). "Coagulation, fibrinolysis and fibrinolysis inhibitors in haemodialysis patients: contribution of arteriovenous fistula". Nephrol. Dial. Transplant. 11 (7): 1299–305. PMID 8672026.
  159. ↑ Uhl M, Richter GM, Kauffmann GW, Herb P, Tüngerthal S (November 1992). "[Pulmonary arteriovenous fistulas in Osler's disease]". Radiologe (in German). 32 (11): 562–7. PMID 1461986.
  160. ↑ Goksu E, Yuruktumen A, Kaya H (May 2014). "Traumatic pseudoaneurysm and arteriovenous fistula detected by bedside ultrasound". J Emerg Med. 46 (5): 667–9. doi:10.1016/j.jemermed.2013.08.136. PMID 24472357.
  161. ↑ Galosi AB, Capretti C, Leone L, Tiroli M, Cantoro D, Polito M (December 2016). "Pseudoaneurysm with arteriovenous fistula of the prostate after pelvic trauma: Ultrasound imaging". Arch Ital Urol Androl. 88 (4): 317–319. doi:10.4081/aiua.2016.4.317. PMID 28073202.
  162. ↑ Pellerito, John (2012). Introduction to vascular ultrasonography. Philadelphia, PA: Saunders/Elsevier. ISBN 143771417X.
  163. ↑ Venkatanarasimha N, Freeman S (June 2010). "Ultrasound features of arteriovenous fistula". AJR Am J Roentgenol. 194 (6): W540, author reply W543. doi:10.2214/AJR.09.3978. PMID 20489077.
  164. ↑ Pellerito, John (2012). Introduction to vascular ultrasonography. Philadelphia, PA: Saunders/Elsevier. ISBN 143771417X.
  165. ↑ Pellerito, John (2012). Introduction to vascular ultrasonography. Philadelphia, PA: Saunders/Elsevier. ISBN 143771417X.
  166. ↑ Roomi AU, Kemaloglu Oz T, Williams SO, Nanda NC, Mehta KJ, Sungur A, McGiffin DC (October 2013). "Two- and three-dimensional transthoracic echocardiography in the assessment of acquired ascending aortic aneurysm to pulmonary artery fistula". Echocardiography. 30 (9): 1107–10. doi:10.1111/echo.12330. PMID 23895668.
  167. ↑ Karam C, Sellier J, Mansencal N, Fagnou C, Blivet S, Chinet T, Lacombe P, Dubourg O (January 2015). "Reliability of contrast echocardiography to rule out pulmonary arteriovenous malformations and avoid CT irradiation in pediatric patients with hereditary hemorrhagic telangiectasia". Echocardiography. 32 (1): 42–8. doi:10.1111/echo.12615. PMID 24813063.
  168. ↑ 168.0 168.1 Miyatake K, Okamoto M, Kinoshita N, Fusejima K, Sakakibara H, Nimura Y (May 1984). "Doppler echocardiographic features of coronary arteriovenous fistula. Complementary roles of cross sectional echocardiography and the Doppler technique". Br Heart J. 51 (5): 508–18. PMC 481541. PMID 6721946.
  169. ↑ 169.0 169.1 169.2 Miller RJ, MacRae JM, Mustata S (September 2014). "Conservative management of an iatrogenic arteriovenous fistula". Nephron Extra. 4 (3): 155–8. doi:10.1159/000366451. PMC 4224231. PMID 25404936.
  170. ↑ Paul AR, Colby GP, Huang J, Tamargo RJ, Coon AL (January 2012). "Selection of treatment modalities or observation of dural arteriovenous fistulas". Neurosurg. Clin. N. Am. 23 (1): 77–85. doi:10.1016/j.nec.2011.09.004. PMID 22107860.
  171. ↑ Niimi Y (March 2017). "Endovascular treatment of pediatric intracranial arteriovenous shunt". Pediatr Int. 59 (3): 247–257. doi:10.1111/ped.13159. PMID 27601322.
  172. ↑ Yokoyama R, Iihoshi S, Miyata K, Toyama K, Komatsu K, Wanibuchi M, Mikuni N (October 2016). "[Pediatric Iatrogenic Vertebral Arteriovenous Fistula Successfully Treated with Endovascular Treatment:A Case Report]". No Shinkei Geka (in Japanese). 44 (10): 857–861. doi:10.11477/mf.1436203390. PMID 27729606.
  173. ↑ Varghese K, Adhyapak SM (May 2017). "Stent Migration during Endovascular Treatment of Traumatic Arteriovenous Fistula following Lumbar Spine Surgery". Ann Vasc Surg. 41: 281.e1–281.e5. doi:10.1016/j.avsg.2016.09.032. PMID 28242409.
  174. ↑ Chaudhary N, Pandey AS, Gemmete JJ (November 2013). "Endovascular treatment of adult spinal arteriovenous lesions". Neuroimaging Clin. N. Am. 23 (4): 729–47. doi:10.1016/j.nic.2013.03.017. PMID 24156861.
  175. ↑ 175.0 175.1 Bagherpour AN, Rodriguez GJ, Moorthy C, Trier TT, Maud A (August 2016). "Combined surgical and endovascular treatment of complex high-flow conus medullaris arteriovenous fistula associated with Parkes Weber syndrome: case report". J Neurosurg Spine. 25 (2): 234–8. doi:10.3171/2016.1.SPINE151156. PMID 27015132.
  176. ↑ Teramoto S, Oishi H, Yoshida K, Yamamoto M, Ohara Y, Arai H (2012). "Paravertebral arteriovenous fistula treated by endovascular coil embolization". Neurol. Med. Chir. (Tokyo). 52 (7): 510–2. PMID 22850502.
  177. ↑ Brown PA, Zomorodi AR, Gonzalez LF (2017). "Endovascular management of spinal dural arteriovenous fistulas". Handb Clin Neurol. 143: 199–213. doi:10.1016/B978-0-444-63640-9.00019-9. PMID 28552142.
  178. ↑ Li J, Li G, Bian L, Hong T, Yu J, Zhang H, Ling F (September 2017). "Concomitant Lumbosacral Perimedullary Arteriovenous Fistula and Spinal Dural Arteriovenous Fistula". World Neurosurg. 105: 1041.e7–1041.e14. doi:10.1016/j.wneu.2017.06.149. PMID 28684369.
  179. ↑ Caplan JM, Groves M, Jusue-Torres I, Kim JE, Liauw J, Bydon A, Tamargo RJ (September 2014). "Microsurgical obliteration of a thoracic spinal perimedullary arteriovenous fistula". Neurosurg Focus. 37 Suppl 2: Video 13. doi:10.3171/2014.V3.FOCUS14376. PMID 25175574.
  180. ↑ 180.0 180.1 Yen CP, Lanzino G, Sheehan JP (October 2013). "Stereotactic radiosurgery of intracranial dural arteriovenous fistulas". Neurosurg. Clin. N. Am. 24 (4): 591–6. doi:10.1016/j.nec.2013.05.008. PMID 24093576.
  181. ↑ Chen CJ, Lee CC, Ding D, Starke RM, Chivukula S, Yen CP, Moosa S, Xu Z, Pan DH, Sheehan JP (February 2015). "Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review". J. Neurosurg. 122 (2): 353–62. doi:10.3171/2014.10.JNS14871. PMID 25479123.
  182. ↑ Park SH, Park KS, Kang DH, Hwang JH, Hwang SK (October 2017). "Stereotactic Radiosurgery for Dural Carotid Cavernous Sinus Fistulas". World Neurosurg. 106: 836–843. doi:10.1016/j.wneu.2017.04.143. PMID 28465265.
  183. ↑ Sung KS, Song YJ, Kim KU (July 2016). "Novalis Stereotactic Radiosurgery for Spinal Dural Arteriovenous Fistula". J Korean Neurosurg Soc. 59 (4): 420–4. doi:10.3340/jkns.2016.59.4.420. PMC 4954894. PMID 27446527.
  184. ↑ Tonetti DA, Gross BA, Jankowitz BT, Atcheson KM, Kano H, Monaco EA, Niranjan A, Lunsford LD (November 2017). "Stereotactic Radiosurgery for Dural Arteriovenous Fistulas without Cortical Venous Reflux". World Neurosurg. 107: 371–375. doi:10.1016/j.wneu.2017.07.170. PMID 28803169.
  185. ↑ Brightwell RE, Pegna V, Boyne N (January 2013). "Aortocaval fistula: current management strategies". ANZ J Surg. 83 (1–2): 31–5. doi:10.1111/j.1445-2197.2012.06294.x. PMID 23072669.
  186. ↑ Lee CH (October 2016). "Stent graft repair of iatrogenic femoral arteriovenous fistula with acute bleeding after hemodialysis catheter insertion". Hemodial Int. 20 (4): 497–500. doi:10.1111/hdi.12431. PMID 27151579.
  187. ↑ Ostras O, Kurkevych A, Bohuta L, Yalynska T, Raad T, Lewin M, Yemets I (April 2015). "Prenatal diagnosis of left pulmonary artery-to-pulmonary vein fistula and its successful surgical repair in a neonate". Tex Heart Inst J. 42 (2): 169–71. doi:10.14503/THIJ-13-3960. PMC 4382888. PMID 25873833.
  188. ↑ Roth P, Heiss C, Koshty A, Niemann B, Boening A (December 2014). "Posttraumatic arteriovenous fistula of the distal posterior tibial artery as cause of delayed wound healing in an unrecognized arterial injury". Thorac Cardiovasc Surg Rep. 3 (1): 67–70. doi:10.1055/s-0033-1363167. PMC 4360614. PMID 25798368.
  189. ↑ Kızıltan HT (July 2018). "A Review of the Exclusion Technique as a Mode of Surgical Repair in the Treatment of Aortoiliac Aneurysms with Spontaneous Arteriovenous Fistulas". Heart Surg Forum. 21 (4): E326–E329. doi:10.1532/hsf.1939. PMID 30084789.
  190. ↑ 190.0 190.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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