Traumatic lumbar artery arteriovenous fistula: preclinically detected by 16-multidetector-row computed tomography and post-processing techniques

Abstract

We report a 21-year-old woman with a penetrating abdominal wound. Injuries of the abdominal aorta and alimentary tract were found during emergency surgery. The patient had a follow-up computed tomography (CT) scan 3 months after surgery. Arterial-phase 16-row multidetector computed tomography (MDCT) showed a suspicious dilated vessel adjacent to the repaired aorta on 5-mm transverse images. A fistula between a lumbar artery and the inferior vena cava was clearly demonstrated on images reformatted with two- (2D) and three-dimensional (3D) techniques. The patient suffered from symptoms of high-output heart failure 8 months after surgery.

A systematic review and individual patient data meta-analysis of heart failure as a rare complication of traumatic arteriovenous fistulas

“…The lumbar artery with a reported diameter of 0.14 cm represents an outlier among AVF feeding arteries in the HF group. 25 Despite its small diameter, HF occurred after injury to this vessel in a patient reported by Chou et al 34 A thorough review of the case led us to assume that the extraordinary anatomic location of the described AVF at the origin of the lumbar artery from the aorta contributed to the development of HF in their patient. HF was rarely observed secondary to AVFs affecting the portal venous system.…”

An in vitro evaluation of the efficacy of Agomelatine in combination with Thapsigargin and 2-Aminoethoxydiphenyl borate for the treatment of type 2 diabetes

“…The authors first attempted coil embolization but upon identifying the continued flow, opted for combination therapy using Histoacryl 4 . In cases with an AVF diagnosis, due to the damage to the vessel wall, acute lesions often develop retroperitoneal hematomas which affect the hemodynamic parameters 9 . With chronic insidious AVF, the clinical presentation can often be non-specific, most commonly dyspnea on exertion due to increased cardiac output or heart failure 9 .…”

“…With chronic insidious AVF, the clinical presentation can often be non-specific, most commonly dyspnea on exertion due to increased cardiac output or heart failure 9 . On CECT, venous drainage can be observed early in the arterial phase, in some cases with associated pseudoaneurysm 9 . DSA is the gold standard for the diagnosis of AVF and it can be used to guide the treatment strategy.…”