Arteriovenous Shunt, Surgical
Arteriovenous Fistula
Cranial Sinuses
Central Nervous System Vascular Malformations
Arteriovenous Malformations
Arteriovenous Anastomosis
Intracranial Arteriovenous Malformations
Bleeding Time
Dura Mater
Phenindione
Embolization, Therapeutic
Ventriculoperitoneal Shunt
Cerebrospinal Fluid Shunts
Hepatic Artery
Cerebral Angiography
Jugular Veins
Papio
Portasystemic Shunt, Surgical
Portacaval Shunt, Surgical
Peritoneovenous Shunt
Platelet Aggregation
Dogs
Hydrocephalus
Hypertension, Portal
Esophageal and Gastric Varices
Hepatic Encephalopathy
Heart Septal Defects, Atrial
Splenic Vein
Portal System
Heart Septal Defects
Gastrointestinal Hemorrhage
Hydrocephalus, Normal Pressure
Foramen Ovale, Patent
Sites of stenosis in AV fistulae for haemodialysis access. (1/955)
BACKGROUND: A large proportion of late failures of radiocephalic arteriovenous fistulae are related to the progression of intimal hyperplasia. The aetiology of this process is still unknown but the fistula configuration and resultant haemodynamics have been implicated. This clinical study was devised to identify sites of stenosis in patients with fistulae and relate the findings to various clinical and geometrical parameters. METHOD: Measurement of anastomotic length and angle was made intraoperatively in 25 consecutive fistulae. Post-operative assessment was carried out at regular intervals using duplex and colour-flow ultrasonography. RESULTS: Stenoses were present in all 25 of the fistulae studied at 3 months. The stenoses could be classified to three specific sites: at the anastomosis (Type 1), on the inner wall of the curved region of the cephalic vein (Type 2) and just proximal to this curved segment where the vein straightens out (Type 3). Most of Type 1 and Type 2 stenoses were not progressive while Type 3 stenoses were generally progressive. CONCLUSION: These findings emphasize the need for an effective surveillance programme of AV fistulae. (+info)Association of plasma fibrinogen concentration with vascular access failure in hemodialysis patients. (2/955)
BACKGROUND: Elevated plasma fibrinogen is an important risk factor for coronary artery disease in the general population and patients with chronic renal failure. High plasma fibrinogen may trigger thrombus formation in arteriovenous fistulas. We performed a prospective, cohort study to evaluate the association of plasma fibrinogen concentration with vascular access failure in patients undergoing long-term haemodialysis. METHODS: Between September 1989 and October 1995, 144 patients underwent a vascular access operation. In March 1997, 102 patients (56 M, 46 F) who had been followed up for more than 18 months (median; 37 months, range; 18-102 months) were included in the study. The median age of the patients was 52 years (range; 19-78 years). In 35 patients, renal disease was secondary to diabetes mellitus. The type of vascular access was a polytetrafluoroethylene (PTFE) graft in 17 patients. Seventy-seven patients received recombinant human erythropoietin (r-HuEPO) therapy during the follow-up period. Plasma fibrinogen, albumin, total cholesterol, hematocrit, platelets and creatinine were measured at the time of operation. Vascular access failure was defined as the occurrence of complications requiring transluminal angioplasty, thrombolytic therapy or surgical repair. RESULTS: Thirty-eight patients had at least one vascular access failure and the incidence was 0.3 (range; 0-2.4) episodes per patient-year. The survival rate of vascular access was 78% (native fistula; 80%, PTFE graft; 71%) after 12 months and 70% (native fistula; 73%, PTFE graft; 51%) after 24 months. Older age, a PTFE graft, r-HuEPO therapy, higher hematocrit, lower albumin and higher fibrinogen levels were significantly associated with vascular access failure, whereas gender, diabetes mellitus, total cholesterol and platelet count were not. Plasma fibrinogen was inversely correlated with albumin (r=-0.38, P=0.001). The cumulative vascular access survival was significantly lower in patients with high plasma fibrinogen levels (> or = 460 mg/dl) compared with patients with low levels (< 460 mg/dl) (P=0.007). Independent risk factors for vascular access failure analysed by Cox's proportional hazards model were older age (RR; 1.36 by 10-year increment), higher fibrinogen level (RR; 1.20 by 100 mg/dl increment), PTFE graft (RR; 2.28) and r-HuEPO therapy (RR; 3.79). CONCLUSION: High plasma fibrinogen level is an independent risk factor for vascular access failure in haemodialysis patients. (+info)Right atrial bypass grafting for central venous obstruction associated with dialysis access: another treatment option. (3/955)
PURPOSE: Central venous obstruction is a common problem in patients with chronic renal failure who undergo maintenance hemodialysis. We studied the use of right atrial bypass grafting in nine cases of central venous obstruction associated with upper extremity venous hypertension. To better understand the options for managing this condition, we discuss the roles of surgery and percutaneous transluminal angioplasty with stent placement. METHODS: All patients had previously undergone placement of bilateral temporary subclavian vein dialysis catheters. Severe arm swelling, graft thrombosis, or graft malfunction developed because of central venous stenosis or obstruction in the absence of alternative access sites. A large-diameter (10 to 16 mm) externally reinforced polytetrafluoroethylene (GoreTex) graft was used to bypass the obstructed vein and was anastomosed to the right atrial appendage. This technique was used to bypass six lesions in the subclavian vein, two lesions at the innominate vein/superior vena caval junction, and one lesion in the distal axillary vein. RESULTS: All patients except one had significant resolution of symptoms without operative mortality. Bypass grafts remained patent, allowing the arteriovenous grafts to provide functional access for 1.5 to 52 months (mean, 15.4 months) after surgery. CONCLUSION: Because no mortality directly resulted from the procedure and the morbidity rate was acceptable, this bypass grafting technique was adequate in maintaining the dialysis access needed by these patients. Because of the magnitude of the procedure, we recommend it only for the occasional patient in whom all other access sites are exhausted and in whom percutaneous dilation and/or stenting has failed. (+info)Volume flow measurement in hemodialysis shunts using time-domain correlation. (4/955)
Volume flow was measured in 58 hemodialysis shunts (32 grafts and 26 radial fistulas) using the color velocity imaging-quantification method. This method is based on time-domain correlation for velocity calculation and integration of time-varying velocity profiles generated by M-mode sampling. Measurements were made in the brachial artery to estimate radial fistula flow or directly in the grafts. Intraoperator reproducibility was 14.9% for fistulas and 11.6% for grafts. Flow rate was significantly lower in abnormal shunts associated with a functional disorder or a morphologic complication (808 ml/min +/- 484) than in shunts associated with no abnormalities (1401 ml/min +/- 562). Receiver operating characteristic curves showed that a flow rate of 900 ml/min for fistulas and 1300 ml/min for grafts provided 81% and 79% sensitivity and 79% and 67% specificity, respectively. A functional disorder or a morphologic complication was associated with all fistulas and grafts in which flow rates were lower than 500 ml/min and 800 ml/min, respectively. (+info)Prospective randomised trial of distal arteriovenous fistula as an adjunct to femoro-infrapopliteal PTFE bypass. (5/955)
OBJECTIVES: To compare graft patency and limb salvage rate following femoro-infrapopliteal bypass using ePTFE grafts with and without the addition of adjuvant arterio-venous fistula. DESIGN: A prospectively randomised controlled trial. MATERIALS: Patients referred to two teaching hospital vascular surgery units in the U.K. for the treatment of critical limb ischaemia. METHODS: Eighty-seven patients (M:F; 2.3:1) undergoing 89 femoro-intrapopliteal bypass operations with ePTFE grafts for critical limb ischaemia were randomly allocated to have AVF included in the operative procedure (n = 48) or to a control group without AVF (n = 41). An interposition vein-cuff was incorporated at the distal anastomosis in all patients. RESULTS: The cumulative rates of primary patency and limb salvage at 1-year after operation for patients with AVF were 55.2% and 54.1% compared to 53.4% and 43.2%, respectively, for the control group. The differences between the AVF and control groups did not reach statistical significance, in terms of either graft patency or limb salvage, at any stage after operation (Log-Rank test). CONCLUSIONS: AVF confers no additional significant clinical advantage over interposition vein cuff in patients having femoro-infrapopliteal bypass with ePTFE grants for critical limb ischaemia. (+info)Homocyst(e)ine and vascular access complications in haemodialysis patients: insights into a complex metabolic relationship. (6/955)
BACKGROUND: As elevated total homocyst(e)ine (tHcy) is associated with increased risk of vascular thrombosis, we hypothesized that the elevated levels of tHcy seen in patients on haemodialysis may be associated with an increased risk of thrombosis of native arteriovenous fistulae (vascular access failure). Our study was designed to investigate the relationship between tHcy and vascular access failure. The relationship between tHcy and mortality was explored as a secondary analysis. METHODS: The study comprised a cross-sectional analysis of 96 haemodialysis patients at a single university-affiliated hospital and a subsequent 9-month prospective follow-up of 88 of the 96 patients. RESULTS: Levels of tHcy (median 30 micromol/l) were elevated. In the initial cross-sectional sample, there was an inverse relationship between tHcy and history of vascular access failure which was not observed in the prospective study. Variables influencing the risk of vascular access failure in the prospective study included history of previous vascular access failure (RR=2.93, P=0.03), use of antiplatelet agents (RR=0.13, P=0.01), increased urea reduction ratio (RR=0.55 for a 5% increase, P=0.01) and increased weight (RR=0.61 for a 10 kg increase, P=0.02). Secondary analysis showed an unexpected inverse relationship between tHcy and mortality (RR=0.033 for 1 log increase in tHcy, P=0.006), such that the lower levels of tHcy were associated with an increased risk of death in short-term follow-up. CONCLUSION: We did not demonstrate a relationship between tHcy and risk of vascular access failure. Patients with the lowest levels of tHcy appeared to be at increased risk of death in this short-term follow-up. The relationship of tHcy to vascular access complications and death in haemodialysis patients appears complex and requires further study. (+info)Effects of arteriovenous fistulas on cardiac oxygen supply and demand. (7/955)
BACKGROUND: Arteriovenous (AV) fistulas used for hemodialysis access may affect cardiac load by increasing the preload while decreasing the afterload. In dogs, AV fistulas have also been shown to affect coronary perfusion negatively. We investigated the net effect of AV fistulas on cardiac oxygen supply and demand. METHODS: Aortic pressure waves were reconstructed from finger pressure recordings obtained on the nonfistula arm using a wave-form filter. Changes in systolic, mean, and diastolic aortic pressure were calculated, together with changes in heart rate (HR), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR) during a 60-second compression of AV fistulas in 10 patients. Changes in cardiac supply and demand were estimated by calculating the area under the aortic pressure curve during diastole [diastolic pressure time index (DPTI)] and systole [systolic pressure time index (SPTI)], respectively. RESULTS: During fistula compression, systolic, mean and diastolic pressure increased by 4.2 +/- 4.3, 2.6 +/- 3.0, and 2.8 +/- 2.9 mm Hg (mean +/- SD, all P < 0.05). The HR decreased by 3.8 +/- 2.5 beats per minute (P < 0.01), and SV decreased 3.7 +/- 6.1% (NS). CO decreased 9.4 +/- 8.6%, and SVR increased 14.3 +/- 11.7% (both P < 0.05). The SPTI increased by 1.5 +/- 1.5 mm Hg.sec (P < 0.01), and the DPTI increased by 7.6 +/- 8.1 mm Hg.sec (14.8% increase, P < 0.05) during compression. The ratio of supply and demand (DPTI/SPTI) improved by 13.5 +/- 13.0% (P < 0.01) when the fistula was compressed. CONCLUSION: AV fistulas have a small effect on left ventricular oxygen demand, but decrease cardiac oxygen supply considerably. (+info)Differential regulation of IGF-I, its receptor and GH receptor mRNAs in the right ventricle and caval vein in volume-loaded genetically hypertensive and normotensive rats. (8/955)
It has been suggested, mainly by in vitro findings, that cardiovascular tissue in the spontaneously hypertensive rat (SHR) should be more prone to proliferate/hypertrophy than that of the Wistar-Kyoto rat (WKY). The present study tests the hypothesis that the tissue of the low-pressure compartment in SHR, being structurally similar to that of the WKY, shows an increased growth response due to activation of the GH-IGF-I system. An aortocaval fistula (ACF) was induced in 64 SHR and WKY male rats and 44 rats served as controls. They were all followed for 1, 2, 4 and 7 days after surgery. In separate groups of SHR (n=4) and WKY (n=3), central venous pressure was measured by telemetry recordings prior to opening of the fistula and for up to 16 h post-surgery. Systolic blood pressure was measured during the week post-surgery. The right ventricular (RV) and the caval vein IGF-I mRNA and RV IGF-I receptor and GH receptor mRNAs were quantitated by means of solution hybridisation assay. In rats with ACF the systolic blood pressure decreased, approximately 29% in SHR and 16% in WKY between 1 and 7 days post-surgery (P<0.05, n=5-6 in each group). SHR with ACF showed a transient elevation in central venous pressure vs WKY. Within the week following fistula induction both strains showed a similar, pronounced increase in RV hypertrophy. SHR with ACF showed a smaller, or even blunted, overall response with respect to activation of the GH-IGF-I system compared with WKY, the latter showing clear-cut elevation of gene expressions. Two days after shunt opening in SHR, RV and caval vein IGF-I mRNA increased by 57% and 108% (P<0.05 for both, n=5-6 in each group) respectively, and these expressions were then turned off, whereas RV GH receptor and IGF-I receptor mRNA expression remained unaffected compared with WKY rats. WKY rats showed on average a later and a greater response of GH-IGF-I system mRNA expression vs SHR. The present in vivo study suggests that the SHR requires less activation of the GH-IGF-I system for creating a given adaptive structural growth response. (+info)The AVF is created by joining a radial or brachial artery to a vein in the forearm or upper arm. The vein is typically a radiocephalic vein, which is a vein that drains blood from the hand and forearm. The fistula is formed by sewing the artery and vein together with a specialized suture material.
Once the AVF is created, it needs time to mature before it can be used for hemodialysis. This process can take several weeks or months, depending on the size of the fistula and the individual patient's healing response. During this time, the patient may need to undergo regular monitoring and testing to ensure that the fistula is functioning properly.
The advantages of an AVF over other types of hemodialysis access include:
1. Improved blood flow: The high-flow path created by the AVF allows for more efficient removal of waste products from the blood.
2. Reduced risk of infection: The connection between the artery and vein is less likely to become infected than other types of hemodialysis access.
3. Longer duration: AVFs can last for several years, providing a reliable and consistent source of hemodialysis access.
4. Improved patient comfort: The fistula is typically located in the arm or forearm, which is less invasive and more comfortable for the patient than other types of hemodialysis access.
However, there are also potential risks and complications associated with AVFs, including:
1. Access failure: The fistula may not mature properly or may become blocked, requiring alternative access methods.
2. Infection: As with any surgical procedure, there is a risk of infection with AVF creation.
3. Steal syndrome: This is a rare complication that occurs when the flow of blood through the fistula interferes with the normal flow of blood through the arm.
4. Thrombosis: The fistula may become occluded due to clotting, which can be treated with thrombolysis or surgical intervention.
In summary, an arteriovenous fistula (AVF) is a type of hemodialysis access that is created by connecting an artery and a vein, providing a high-flow path for hemodialysis. AVFs offer several advantages over other types of hemodialysis access, including improved blood flow, reduced risk of infection, longer duration, and improved patient comfort. However, there are also potential risks and complications associated with AVFs, including access failure, infection, steal syndrome, and thrombosis. Regular monitoring and testing are necessary to ensure that the fistula is functioning properly and to minimize the risk of these complications.
The different types of CNSVMs include:
1. Arteriovenous malformations (AVMs): These are abnormal connections between arteries and veins that can cause bleeding, seizures, and neurological deficits.
2. Cavernous malformations: These are abnormal collections of blood vessels that can cause seizures, headaches, and neurological deficits.
3. Capillary telangiectasia: These are small, fragile blood vessels that can cause seizures, headaches, and neurological deficits.
4. Venous malformations: These are abnormalities of the veins that can cause neurological symptoms and cosmetic deformities.
The diagnosis of CNSVMs is based on a combination of clinical presentation, imaging studies (such as MRI or CT scans), and angiography. Treatment options vary depending on the type and location of the malformation and may include observation, surgery, embolization, or radiosurgery. The prognosis for CNSVMs varies depending on the specific type and location of the malformation, as well as the severity of the symptoms. In general, early diagnosis and treatment can improve outcomes and reduce the risk of complications.
AVMs are characterized by a tangle of abnormal blood vessels that can cause a variety of symptoms, including:
* Headaches
* Seizures
* Stroke-like episodes
* Neurological deficits such as weakness or numbness
* Vision problems
* Pain
AVMs can be diagnosed through a combination of imaging studies such as CT or MRI scans, and catheter angiography. Treatment options for AVMs include:
* Endovascular embolization, which involves using a catheter to inject materials into the abnormal blood vessels to block them off
* Surgery to remove the AVM
* Radiation therapy to shrink the AVM
The goal of treatment is to prevent bleeding, seizures, and other complications associated with AVMs. In some cases, treatment may not be necessary if the AVM is small and not causing any symptoms. However, in more severe cases, prompt treatment can significantly improve outcomes.
There are several types of intracranial AVMs, including:
1. Cerebral AVMs: These are the most common type of AVM and occur in the cerebral hemispheres of the brain.
2. Spinal AVMs: These occur in the spinal cord and are less common than cerebral AVMs.
3. Multiple AVMs: Some people may have multiple AVMs, which can be located in different parts of the brain or spine.
The symptoms of intracranial AVMs can vary depending on the location and size of the malformation. They may include:
1. Seizures: AVMs can cause seizures, which can be a sign of the malformation.
2. Headaches: Patients with AVMs may experience frequent and severe headaches.
3. Weakness or numbness: AVMs can cause weakness or numbness in the arms or legs.
4. Vision problems: AVMs can affect the vision, including blurriness, double vision, or loss of peripheral vision.
5. Confusion or disorientation: Patients with AVMs may experience confusion or disorientation.
6. Seizures: AVMs can cause seizures, which can be a sign of the malformation.
7. Cranial nerve deficits: AVMs can affect the cranial nerves, leading to problems with speech, hearing, or facial movements.
8. Hydrocephalus: AVMs can cause hydrocephalus, which is an accumulation of fluid in the brain.
The diagnosis of intracranial AVMs is based on a combination of clinical symptoms, neuroimaging studies such as CT or MRI scans, and angiography. Angiography is a test that uses dye and X-rays to visualize the blood vessels in the brain.
Treatment of intracranial AVMs usually involves a multidisciplinary approach, including neurosurgeons, interventional neuroradiologists, and neurologists. Treatment options may include:
1. Observation: Small AVMs that are not causing symptoms may be monitored with regular imaging studies to see if they grow or change over time.
2. Endovascular embolization: This is a minimally invasive procedure in which a catheter is inserted through a blood vessel in the leg and directed to the AVM in the brain. Once there, the catheter releases tiny particles that block the flow of blood into the AVM, causing it to shrink or disappear.
3. Surgery: In some cases, surgery may be necessary to remove the AVM. This is usually done when the AVM is large or in a location that makes it difficult to treat with endovascular embolization.
4. Radiation therapy: This may be used to shrink the AVM before surgery or as a standalone treatment.
5. Chemotherapy: This may be used in combination with radiation therapy to treat AVMs that are caused by a genetic condition called hereditary hemorrhagic telangiectasia (HHT).
The choice of treatment depends on the location and size of the AVM, as well as the patient's overall health and other medical conditions. In some cases, a combination of treatments may be necessary to achieve the best outcome.
There are several types of thrombosis, including:
1. Deep vein thrombosis (DVT): A clot forms in the deep veins of the legs, which can cause swelling, pain, and skin discoloration.
2. Pulmonary embolism (PE): A clot breaks loose from another location in the body and travels to the lungs, where it can cause shortness of breath, chest pain, and coughing up blood.
3. Cerebral thrombosis: A clot forms in the brain, which can cause stroke or mini-stroke symptoms such as weakness, numbness, or difficulty speaking.
4. Coronary thrombosis: A clot forms in the coronary arteries, which supply blood to the heart muscle, leading to a heart attack.
5. Renal thrombosis: A clot forms in the kidneys, which can cause kidney damage or failure.
The symptoms of thrombosis can vary depending on the location and size of the clot. Some common symptoms include:
1. Swelling or redness in the affected limb
2. Pain or tenderness in the affected area
3. Warmth or discoloration of the skin
4. Shortness of breath or chest pain if the clot has traveled to the lungs
5. Weakness, numbness, or difficulty speaking if the clot has formed in the brain
6. Rapid heart rate or irregular heartbeat
7. Feeling of anxiety or panic
Treatment for thrombosis usually involves medications to dissolve the clot and prevent new ones from forming. In some cases, surgery may be necessary to remove the clot or repair the damaged blood vessel. Prevention measures include maintaining a healthy weight, exercising regularly, avoiding long periods of immobility, and managing chronic conditions such as high blood pressure and diabetes.
There are several types of hydrocephalus, including:
1. Aqueductal stenosis: This occurs when the aqueduct that connects the third and fourth ventricles becomes narrowed or blocked, leading to an accumulation of CSF in the brain.
2. Choroid plexus papilloma: This is a benign tumor that grows on the surface of the choroid plexus, which is a layer of tissue that produces CSF.
3. Hydrocephalus ex vacuo: This occurs when there is a decrease in the volume of brain tissue due to injury or disease, leading to an accumulation of CSF.
4. Normal pressure hydrocephalus (NPH): This is a type of hydrocephalus that occurs in adults and is characterized by an enlarged ventricle, gait disturbances, and cognitive decline, despite normal pressure levels.
5. Symptomatic hydrocephalus: This type of hydrocephalus is caused by other conditions such as brain tumors, cysts, or injuries.
Symptoms of hydrocephalus can include headache, nausea, vomiting, seizures, and difficulty walking or speaking. Treatment options for hydrocephalus depend on the underlying cause and may include medication, surgery, or a shunt to drain excess CSF. In some cases, hydrocephalus can be managed with lifestyle modifications such as regular exercise and a balanced diet.
Prognosis for hydrocephalus varies depending on the underlying cause and severity of the condition. However, with timely diagnosis and appropriate treatment, many people with hydrocephalus can lead active and fulfilling lives.
Note: Portal hypertension is a common complication of liver disease, especially cirrhosis. It is characterized by elevated pressure within the portal vein system, which can lead to splanchnic vasodilation, increased blood flow, and edema in the splanchnic organ.
Symptoms: Symptoms of portal hypertension may include ascites (fluid accumulation in the abdomen), encephalopathy (mental confusion or disorientation), gastrointestinal bleeding, and jaundice (yellowing of the skin and eyes).
Diagnosis: The diagnosis of portal hypertension is based on a combination of clinical findings, laboratory tests, and imaging studies. Laboratory tests may include liver function tests, blood counts, and coagulation studies. Imaging studies may include ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI).
Treatment: Treatment of portal hypertension depends on the underlying cause and may include medications to control symptoms, such as beta blockers to reduce portal pressure, antibiotics to treat infection, and nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain. In severe cases, surgery or shunt procedures may be necessary.
Prognosis: The prognosis for patients with portal hypertension is generally poor, as it is often associated with advanced liver disease. The 5-year survival rate for patients with cirrhosis and portal hypertension is approximately 50%.
Portal hypertension can be caused by several conditions, such as cirrhosis (scarring of the liver), liver cancer, and congenital heart disease. When the portal vein is blocked or narrowed, blood flow through the veins in the esophagus and stomach increases, leading to enlargement of these vessels and an increased risk of bleeding.
Esophageal varices are the most common type of variceal bleeding and account for about 75% of all cases. Gastric varices are less common and usually occur in conjunction with esophageal varices.
Symptoms of esophageal and gastric varices may include:
* Vomiting blood or passing black stools
* Weakness, dizziness, or fainting due to blood loss
* Chest pain or discomfort
* Difficulty swallowing
Treatment for esophageal and gastric varices usually involves endoscopy, which is a procedure in which a flexible tube with a camera and light on the end is inserted through the mouth to visualize the inside of the esophagus and stomach. During endoscopy, the physician may use medications to shrink the varices or apply heat to seal off the bleeding vessels. In some cases, surgery may be necessary to repair or remove the varices.
Prevention of esophageal and gastric varices involves managing the underlying cause of portal hypertension, such as cirrhosis or liver cancer. This can include medications to reduce portal pressure, lifestyle changes to improve liver function, and in some cases, surgery to remove the affected liver tissue.
In summary, esophageal and gastric varices are enlarged veins in the lower esophagus and stomach that can develop in people with portal hypertension due to cirrhosis or liver cancer. These varices can cause bleeding, which can be life-threatening if not treated promptly. Treatment usually involves endoscopy and may involve medications, heat therapy, or surgery to seal off the bleeding vessels. Prevention involves managing the underlying cause of portal hypertension.
This condition is most commonly seen in people with advanced liver disease, such as cirrhosis or liver cancer. It can also be caused by other conditions that affect the liver, such as hepatitis or portal hypertension.
Symptoms of hepatic encephalopathy can include confusion, disorientation, slurred speech, memory loss, and difficulty with coordination and balance. In severe cases, it can lead to coma or even death.
Diagnosis of hepatic encephalopathy is typically made through a combination of physical examination, medical history, and diagnostic tests such as blood tests and imaging studies. Treatment options include medications to reduce the production of ammonia in the gut, antibiotics to treat any underlying infections, and transjugular intrahepatic portosystemic shunt (TIPS) to improve liver function. In severe cases, a liver transplant may be necessary.
Overall, hepatic encephalopathy is a serious condition that can have significant impact on quality of life and survival in people with advanced liver disease. Early detection and prompt treatment are essential to prevent complications and improve outcomes.
Treatment options for ascites include medications to reduce fluid buildup, dietary restrictions, and insertion of a catheter to drain the fluid. In severe cases, a liver transplant may be necessary. It is important to seek medical attention if symptoms persist or worsen over time.
Ascites is a serious condition that requires ongoing management and monitoring to prevent complications and improve quality of life.
There are several types of heart septal defects, including:
1. Atrial septal defect (ASD): A hole in the wall between the two upper chambers (atria) of the heart.
2. Ventricular septal defect (VSD): A hole in the wall between the two lower chambers (ventricles) of the heart.
3. Patent ductus arteriosus (PDA): A connection between the aorta and the pulmonary artery that should close shortly after birth but fails to do so.
4. Atresia: The absence of an opening between the two lower chambers (ventricles) of the heart, which can lead to a lack of oxygenation of the body.
Heart septal defects can be caused by genetic factors or environmental factors such as maternal viral infections during pregnancy. They are often diagnosed during infancy or early childhood, and treatment options may include medication, surgery, or catheter-based procedures to close the abnormal opening or hole.
Untreated heart septal defects can lead to complications such as heart failure, atrial arrhythmias, and lung damage. However, with timely and appropriate treatment, many individuals with heart septal defects can lead normal, active lives with minimal long-term effects.
The severity of GIH can vary widely, ranging from mild to life-threatening. Mild cases may resolve on their own or with minimal treatment, while severe cases may require urgent medical attention and aggressive intervention.
Gastrointestinal Hemorrhage Symptoms:
* Vomiting blood or passing black tarry stools
* Hematemesis (vomiting blood)
* Melena (passing black, tarry stools)
* Rectal bleeding
* Abdominal pain
* Fever
* Weakness and dizziness
Gastrointestinal Hemorrhage Causes:
* Peptic ulcers
* Gastroesophageal reflux disease (GERD)
* Inflammatory bowel disease (IBD)
* Diverticulosis and diverticulitis
* Cancer of the stomach, small intestine, or large intestine
* Vascular malformations
Gastrointestinal Hemorrhage Diagnosis:
* Physical examination
* Medical history
* Laboratory tests (such as complete blood count and coagulation studies)
* Endoscopy (to visualize the inside of the gastrointestinal tract)
* Imaging studies (such as X-rays, CT scans, or MRI)
Gastrointestinal Hemorrhage Treatment:
* Medications to control bleeding and reduce acid production in the stomach
* Endoscopy to locate and treat the site of bleeding
* Surgery to repair damaged blood vessels or remove a bleeding tumor
* Blood transfusions to replace lost blood
Gastrointestinal Hemorrhage Prevention:
* Avoiding alcohol and spicy foods
* Taking medications as directed to control acid reflux and other gastrointestinal conditions
* Maintaining a healthy diet and lifestyle
* Reducing stress
* Avoiding smoking and excessive caffeine consumption.
Symptoms of hydrocephalus, normal pressure can include headaches, nausea and vomiting, double vision, and difficulty with balance and coordination. However, unlike hydrocephalus, elevated pressure, which is caused by an excessive accumulation of CSF, the symptoms of hydrocephalus, normal pressure are usually milder and may not be as severe.
Treatment options for hydrocephalus, normal pressure can include medications to relieve symptoms, such as headaches and nausea, as well as surgery to drain excess CSF or to repair any blockages or abnormalities in the flow of CSF. In some cases, a shunt may be inserted to drain excess CSF into another part of the body, such as the abdomen.
Also known as: Foramen ovale, patent; Patent foramen ovale; PFO.
Anastomosis
List of MeSH codes (E04)
Acroangiodermatitis
Technological and industrial history of 20th-century Canada
Acrocyanosis
Vascular myelopathy
Bonnet-Dechaume-Blanc syndrome
Hemangioendothelioma
Paradoxical embolism
Fabian Udekwu
Vein of Galen aneurysmal malformations
Dural arteriovenous fistula
Transthoracic echocardiogram
Fistula
Interventional radiology
Intracranial hemorrhage
Cone beam computed tomography
Superficial siderosis
Sickle cell retinopathy
Arteriovenous malformation
Miguel A. Faria Jr.
Infantile hemangioma
Ultrasonography of liver tumors
Hypoxemia
Claude Franceschi
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum
Cardiac output
Transposition of the great vessels
Seizure
Neurosurgery
Subarachnoid hemorrhage
Sodium nitroprusside
Chiari malformation
Appendix A
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Atgam, ATG equine (antithymocyte globulin equine) dosing, indications, interactions, adverse effects, and more.
skunk works - A Surgeon's Notes
The Role of Macrophage in the Pathogenesis of Brain Arteriovenous Malformation | Ma | International Journal of Hematology...
Index by author - January 01, 2001, 22 (1) | American Journal of Neuroradiology
Document 9186
Fistula5
- Spinal dural arteriovenous fistula (SDAVF) is a rare disease, whose etiology is not entirely clear. (jneuro.org)
- All selected patients underwent surgical closure of the fistula. (jneuro.org)
- ABSTRACT Objectives: to validate a care protocol for the monitoring and prevention of arteriovenous fistula complications. (bvsalud.org)
- An "arteriovenous fistula for dialysis" or "AV fistula for dialysis" is made by surgically connecting an artery and a vein in your arm, or in some cases, your leg. (medfin.in)
- To the best of our knowledge, only 4 cases of arteriovenous fistula (AVFs) involving the PCV have been reported so far. (neuroangio.org)
Malformations6
- McCormick published an influential classification system in "The Pathology of Vascular ('Arteriovenous') Malformations. (medscape.com)
- Luschka and Virchow originally described arteriovenous malformations (AVMs) in the mid 1800s. (medscape.com)
- If bubbles appear in the left heart, it may indicate a shunt, such as a patent foramen ovale , atrial septal defect , ventricular septal defect or arteriovenous malformations in the lungs. (wikipedia.org)
- Brain arteriovenous malformations (BAVMs) are complexes of tortuous, tangled vessels located in the brain parenchyma, in which a loss of normal capillary bed results in fistulous connections between arteries and veins. (ghrnet.org)
- Posterior fossa arteriovenous malformations (AVMs) can be a challenging disease, especially those large in size. (scite.ai)
- Background: Arteriovenous malformations (AVMs) are relatively uncommon congenital vascular anomalies, and only 7-15% of AVMs occur in the posterior fossa. (scite.ai)
Malformation4
- This axial T2-weighted MRI shows arteriovenous malformation nidus on the right side. (medscape.com)
- Brain arteriovenous malformation (BAVM) is an important risk factor for intracranial hemorrhage, especially in children and young adults. (ghrnet.org)
- We present a case of brain abscess induced by embolization of an arteriovenous malformation (AVM), discuss the main indications, techniques, procedural complications, and review the associated literature. (scite.ai)
- Conclusion: The patient showed significant clinical improvement after surgical resection of the malformation. (scite.ai)
Vascular4
- Spinal dural arteriovenous fistulas (SDAVFs) are rare complex spinal vascular shunts, which can inevitably lead to severe disability if remain untreated. (jneuro.org)
- The Department of Vascular Surgery offers the full range of diagnostic services and surgical interventions for patients with diseases of the arteries, veins, and lymphatic vessels. (bookinghealth.com)
- Also, they specialize in the surgical treatment of vascular pathologies and thyroid diseases. (bookinghealth.com)
- Abnormal arteriovenous shunting contributes to high flow in focal vascular structures, especially in the tangled nidus and draining veins. (ghrnet.org)
Microsurgical2
- They all underwent microsurgical shunt interruption. (jneuro.org)
- During the 20th century, microsurgical laboratories arose and provided a way to develop surgical skills. (scite.ai)
Artery3
- Surgical shunt allowing direct passage of blood from an artery to a vein. (bvsalud.org)
- They are defined as direct arteriovenous shunts in the spinal dura mater between a segmental root artery and a peri-medullary vein [2]. (jneuro.org)
- SDAVF treatment consists of interrupting the shunt between the artery and the vein either surgically or endovascularly. (jneuro.org)
Complications1
- Among 20 surgical procedures, there were complications in three cases (15%): epidural hematoma in 1 case, cerebrospinal fluid leakage in 1 case, and postoperative wound infection in 1 case. (jneuro.org)
Neurological1
- His extensive experience includes trauma nursing at a level-I trauma center, and staff positions in Neurological, Coronary, Medical and Surgical Intensive Care Units. (abcdocz.com)
Catheter1
- Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis. (duke.edu)
Pathology1
- The success rate of these procedures varies with the pathology, the patient, and surgical performance. (scite.ai)
Brain1
- Neurosurgical pathologies are a set of conditions that affect the brain, spinal cord, and cranial pairs requiring medical and surgical management. (bvsalud.org)
Procedures1
- Procedures were performed by 2 surgeons: one experienced surgeon and another young surgeon with surgical qualification. (neurosurgery.directory)
Interventions1
- The Feldenkrais method is presumably preferred by social groups who generally strive to use non-drug and non-surgical interventions for preventing and treating diseases. (bvsalud.org)
Lesions1
- The arteriovenous (AV) shunt is the definitive characteristic of these lesions. (medscape.com)
Therapy1
- The patient refused surgical intervention, and dual antibiotic therapy was continued indefinitely. (cdc.gov)
Operative1
- PURPOSE: Various operative treatment options for advanced thumb carpometacarpal (CMC) joint arthritis have been presented without a definite surgical guideline. (bvsalud.org)
Vein1
- The main surgical difficulty is locating the origin of the shunting vein [9]. (jneuro.org)
Patients1
- Il s'agit d'une étude rétrospective descriptive et analytique, multicentrique portant sur des patients de moins de 5ans pris en charge pour une affection neurochirurgicale de Janvier 2019 à Décembre 2021 à Libreville. (bvsalud.org)
Procedure2
- A procedure consisting of the SURGICAL ANASTOMOSIS of the proximal part of the JEJUNUM to the distal portion of the ILEUM, so as to bypass the nutrient-absorptive segment of the SMALL INTESTINE. (ouhsc.edu)
- Before starting hemodialysis, you need to undergo a surgical procedure to have access placed in your body, which makes it easier to receive dialysis. (medfin.in)
Blood2
- The direct connection between the arterial and venous systems supplies a low-resistance shunt for arterial blood and exposes the venous system to abnormally high pressures. (medscape.com)
- The department offers all the modern surgical options for the treatment of diseases of the abdominal cavity and blood vessels. (bookinghealth.com)
Treatment1
- Individual ALS scores of each patient (pretreatment and post-treatment) were recorded to find out the p-value of the surgical intervention. (jneuro.org)
Skills1
- Such training in advanced surgical skills is now more vital than ever, as many Ukrainians are being severely injured and wounded in the russian-Ukrainian war. (razomforukraine.org)
Medical1
- David presents seminars throughout the country on a variety of topics including critical care and medical-surgical nursing, and has published articles in Nursing, RN, and Image. (abcdocz.com)
Fistula1
- The benefits of an arteriovenous fistula (AVF) as the preferred vascular access for hemodialysis have been clearly demonstrated. (nih.gov)
Hemodialysis1
- Is there a role of angiotensin-converting enzyme gene polymorphism in the failure of arteriovenous femoral shunts for hemodialysis? (nih.gov)
Graft1
- We used logistic regression model with outcome being the initial predialysis placement of an AVF as opposed to an arteriovenous graft or a central venous catheter. (nih.gov)
Tumors5
- This may include cessation of exogenous erythropoietin, repair of shunts or removal of tumors that are secreting erythropoietin. (medscape.com)
- 7. Treatment of glomus tympanicum tumors by preoperative embolization and total surgical resection. (nih.gov)
- 11. Angiographic differential diagnosis of tumors of the glomus caroticum and jugulo-tympanicum and of arterio-venous shunts in the head and neck. (nih.gov)
- 13. Middle ear and mastoid glomus tumors (glomus tympanicum): an algorithm for the surgical management. (nih.gov)
- 19. Surgical management of glomus jugulare tumors: a proposal for approach selection based on tumor relationships with the facial nerve. (nih.gov)
Polycythemia2
- Some cases of secondary polycythemia are caused by conditions that can be ameliorated by surgical removal or correction. (medscape.com)
- Patients who have arteriovenous or intracardiac shunting can present with polycythemia without hypoxemia. (medscape.com)
Treatment3
- Surgical excision is the only curative treatment for these lesions. (medscape.com)
- The treatment of choice is surgical excision with removal of normal bony margins by drill. (medscape.com)
- When conservative and noninvasive treatment measures fail to resolve foot infections, surgical intervention is required. (medscape.com)
Management1
- Guidelines for the management of complicated skin and soft-tissue infections have been published by the Surgical Infection Society (SIS). (medscape.com)