Closure of arteriovenous fistulae and malformations
Summary
Arteriovenous (AV) fistulae are abnormal connections between arteries and veins bypassing interposed arterioles, capillaries and venules. The occurrence and type of clinical manifestations and treatments for AV fistulae depend on the fistula size and vascular territory involved. Frequently, AV fistulae do not require percutaneous or surgical intervention. When treatment is indicated, provided it is technically feasible, percutaneous intervention is the preferred approach. Methods and equipment depend on the fistula size and location. The following chapter aims to provide an overview of the most commonly encountered fistulae, including clinical manifestations and treatment.
Introduction
An arteriovenous (AV) fistula is an abnormal connection between an artery and a vein bypassing interposed arterioles, capillaries and venules. This typically causes dilatation of the veins it feeds due to transmission of arterial pressure to the venous system. AV fistulae are rare and can be inherited (congenital), or acquired. Acquired fistulae are the consequence of trauma, erosion of an aneurysmal artery into a vein or iatrogenic (e.g., related to arterial and venous puncture for the purpose of catheterisation or to surgical creation of an arteriovenous connection to facilitate haemodialysis). General pathophysiological concepts which apply to any arteriovenous fistula are ischaemia in the territory supplied by...
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