Everything you need to know about a complex AV fistula

What is a complex AV fistula and what causes it?


A complex arteriovenous fistula is an abnormal passageway way between a vein and artery. This can occur anywhere in the body; however it is most commonly found in the head, neck spine and liver. If the passageway is abnormal, it can cause swelling in both the artery and vein and increase blood flow to through the area. Doctors can find the location of the AV fistula by listening with a stethoscope to find a continuous murmur.


A complex AV fistula does not always have a clear origin, however can be caused by a number of different factors. For example it can be congenital (meaning that it is from birth), created during surgery for haemodialysis treatments or due to pathologic process (as a consequence of a disease or trauma).



For patients with a complex AV fistula, the heart will be working at an increased rate to ensure that all tissue maintain a normal blood flow. A complex AV fistula will usually occurs in an older patients (around the age of 50-60), however can also occur in younger patients and children.


Symptoms


· Seizures

· Severe headache

· Vomiting

· Nausea

· Altered vision

· Difficulty with balance

· Difficulty with speech and/or hearing


Treatment options


Endovascular embolization is the most common treatment that is used for patients with complex AV fistula. During this procedure a catheter is inserted into an artery, which is then moved to where the fistula is, using fluoroscopic or X-ray imaging. A material is then injected into the exact location to cut off blood flow between the affected vein and artery. Once the flow has been stopped, the complex AV fistula is cured and is unlikely to reoccur.


When an AV fistula is located near the brain, different treatments can be used to remove the fistula. One option is to perform microsurgery, this can be done alone or in conjunction with an endovascular embolization. During this procedure a titanium clip is placed over the abnormal connection to stop the blood flow. An X-ray is usually performed after the procedure to confirm that the treatment has been successful. Stereotactic radiosurgery is another treatment that can be used to treat an AV fistula. This method is usually used when the other two treatment would be too risky, as the fistula is located near to an important brain structure. This is a painless treatment that can take as little as 30 minutes, with nearly all patient returning home after the treatment is complete.


This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

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Domenico Valenti produced by 2xN Limited

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