Fistula, arteriovenous Q27.3

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Pathological connection between artery and vein with consecutive arteriovenous shunt volume.

Etiopathogenesis
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Congenital, usually in the context of other malformations, e.g. Parkes-Weber syndrome, acquired mainly through perforating vascular injuries.

Clinical features
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Fistula murmur (systolic-diastolic buzzing), positive Nicoladoni-Branham test: in case of compression of the afferent artery, bradycardia occurs (lower shunt volume). Possibly unilateral varices. Fistulas between larger vessels lead to right heart strain due to the increase in cardiac output and finally to cardiac insufficiency.

Diagnosis
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Venous occlusion plethysmography (increased arterial inflow compared to the healthy side), ultrasound Doppler examination (continuous flow noise), nuclear medical determination of the arteriovenous shunt volume (injection of radioactively marked millimicrospheres), preoperative angiography.

Therapy
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Operative removal of the fistula, alternatively embolization.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020