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Arteriovenous fistula

MedGen UID:
2041
Concept ID:
C0003855
Anatomical Abnormality
Synonyms: Arteriovenous Fistula; Arteriovenous Fistulas; Fistula, Arteriovenous; Fistulas, Arteriovenous
SNOMED CT: AV - Arteriovenous fistula (128617001); Arteriovenous shunt (128617001); Arteriovenous fistula (128617001); Arteriovenous fistula (439470001)
 
HPO: HP:0004947

Definition

An abnormal connection between an artery and vein. [from HPO]

Conditions with this feature

Angioosteohypertrophic syndrome
MedGen UID:
9646
Concept ID:
C0022739
Disease or Syndrome
Klippel-Trenaunay syndrome is a condition that affects the development of blood vessels, soft tissues (such as skin and muscles), and bones. The disorder has three characteristic features: a red birthmark called a port-wine stain, abnormal overgrowth of soft tissues and bones, and vein malformations.\n\nMost people with Klippel-Trenaunay syndrome are born with a port-wine stain. This type of birthmark is caused by swelling of small blood vessels near the surface of the skin. Port-wine stains are typically flat and can vary from pale pink to deep maroon in color. In people with Klippel-Trenaunay syndrome, the port-wine stain usually covers part of one limb. The affected area may become lighter or darker with age. Occasionally, port-wine stains develop small red blisters that break open and bleed easily.\n\nKlippel-Trenaunay syndrome is also associated with overgrowth of bones and soft tissues beginning in infancy. Usually this abnormal growth is limited to one limb, most often one leg. However, overgrowth can also affect the arms or, rarely, the torso. The abnormal growth can cause pain, a feeling of heaviness, and reduced movement in the affected area. If the overgrowth causes one leg to be longer than the other, it can also lead to problems with walking.\n\nMalformations of veins are the third major feature of Klippel-Trenaunay syndrome. These abnormalities include varicose veins, which are swollen and twisted veins near the surface of the skin that often cause pain. Varicose veins usually occur on the sides of the upper legs and calves. Veins deep in the limbs can also be abnormal in people with Klippel-Trenaunay syndrome. Malformations of deep veins increase the risk of a type of blood clot called a deep vein thrombosis (DVT). If a DVT travels through the bloodstream and lodges in the lungs, it can cause a life-threatening blood clot known as a pulmonary embolism (PE).\n\nOther complications of Klippel-Trenaunay syndrome can include a type of skin infection called cellulitis, swelling caused by a buildup of fluid (lymphedema), and internal bleeding from abnormal blood vessels. Less commonly, this condition is also associated with fusion of certain fingers or toes (syndactyly) or the presence of extra digits (polydactyly).
Angiokeratoma corporis diffusum with arteriovenous fistulas
MedGen UID:
324953
Concept ID:
C1838141
Disease or Syndrome
Capillary malformation-arteriovenous malformation 1
MedGen UID:
1648501
Concept ID:
C4747394
Disease or Syndrome
Capillary malformation-arteriovenous malformation (CM-AVM) syndrome is characterized by the presence of multiple small (1-2 cm in diameter) capillary malformations mostly localized on the face and limbs. Some affected individuals also have associated arteriovenous malformations (AVMs) and/or arteriovenous fistulas (AFVs), fast-flow vascular anomalies that typically arise in the skin, muscle, bone, spine, and brain; life-threatening complications of these lesions can include bleeding, congestive heart failure, and/or neurologic consequences. Symptoms from intracranial AVMs/AVFs appear to occur early in life. Several individuals have Parkes Weber syndrome (multiple micro-AVFs associated with a cutaneous capillary stain and excessive soft-tissue and skeletal growth of an affected limb).

Professional guidelines

PubMed

Roy S, Kabach M, Patel DB, Guzman LA, Jovin IS
Cardiovasc Revasc Med 2022 Jul;40:163-171. Epub 2021 Dec 16 doi: 10.1016/j.carrev.2021.12.007. PMID: 34952824
Baharvahdat H, Ooi YC, Kim WJ, Mowla A, Coon AL, Colby GP
Stroke Vasc Neurol 2020;5(1):50-58. Epub 2019 Nov 21 doi: 10.1136/svn-2019-000269. PMID: 32411408Free PMC Article
Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Martí-Monrós A, Del Pozo JL, Gruss E, Ramírez de Arellano M, Fontseré N, Arenas MD, Merino JL, García-Revillo J, Caro P, López-Espada C, Giménez-Gaibar A, Fernández-Lucas M, Valdés P, Fernández-Quesada F, de la Fuente N, Hernán D, Arribas P, Sánchez de la Nieta MD, Martínez MT, Barba Á; por el Grupo Español Multidisciplinar del Acceso Vascular (GEMAV)
Nefrologia 2017 Nov;37 Suppl 1:1-191. doi: 10.1016/j.nefro.2017.11.004. PMID: 29248052

Recent clinical studies

Etiology

Gunawardena T, Ridgway D
Semin Dial 2022 Jul;35(4):307-316. Epub 2022 Apr 27 doi: 10.1111/sdi.13086. PMID: 35475553
Nelson PR, Mallios A, Randel M, Jennings WC
Semin Vasc Surg 2021 Dec;34(4):195-204. Epub 2021 Oct 30 doi: 10.1053/j.semvascsurg.2021.10.010. PMID: 34911625
Spatola L, Rivera RF, Mugnai G
Int Urol Nephrol 2021 Dec;53(12):2541-2548. Epub 2021 Mar 16 doi: 10.1007/s11255-021-02830-w. PMID: 33725293
Bulbul E, Enc N
J Vasc Access 2021 Mar;22(2):178-183. Epub 2020 Jun 18 doi: 10.1177/1129729820933753. PMID: 32552344
Bashar K, Conlon PJ, Kheirelseid EA, Aherne T, Walsh SR, Leahy A
Surgeon 2016 Oct;14(5):294-300. Epub 2016 Mar 15 doi: 10.1016/j.surge.2016.02.001. PMID: 26988630

Diagnosis

Grant Y, Freilich S, Horwitz MD, Shemesh D, Crane J
J Vasc Access 2021 Sep;22(5):795-800. Epub 2020 Aug 11 doi: 10.1177/1129729820948690. PMID: 32779515Free PMC Article
Abreo K, Amin BM, Abreo AP
J Vasc Access 2019 Jan;20(1):7-11. Epub 2018 Apr 9 doi: 10.1177/1129729818768183. PMID: 29627998
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Malloy TR, Leberman PR, Murphy JJ
J Urol 1967 Jul;98(1):40-3. doi: 10.1016/S0022-5347(17)62819-2. PMID: 6032816

Therapy

Pinto R, Sousa C, Salgueiro A, Fernandes I
J Vasc Access 2022 Sep;23(5):825-831. Epub 2021 Apr 30 doi: 10.1177/11297298211006972. PMID: 33926285
Lindhard K, Rix M, Heaf JG, Hansen HP, Pedersen BL, Jensen BL, Hansen D
BMC Nephrol 2021 Aug 21;22(1):283. doi: 10.1186/s12882-021-02476-x. PMID: 34419006Free PMC Article
Mohr JP, Overbey JR, Hartmann A, Kummer RV, Al-Shahi Salman R, Kim H, van der Worp HB, Parides MK, Stefani MA, Houdart E, Libman R, Pile-Spellman J, Harkness K, Cordonnier C, Moquete E, Biondi A, Klijn CJM, Stapf C, Moskowitz AJ; ARUBA co-investigators
Lancet Neurol 2020 Jul;19(7):573-581. doi: 10.1016/S1474-4422(20)30181-2. PMID: 32562682
Viecelli AK, Mori TA, Roy-Chaudhury P, Polkinghorne KR, Hawley CM, Johnson DW, Pascoe EM, Irish AB
Semin Dial 2018 May;31(3):244-257. Epub 2017 Nov 26 doi: 10.1111/sdi.12658. PMID: 29178510
Oparil S, Schmieder RE
Circ Res 2015 Mar 13;116(6):1074-95. doi: 10.1161/CIRCRESAHA.116.303603. PMID: 25767291

Prognosis

Li J, Zeng G, Zhi X, Bian L, Yang F, Du J, Ling F, Zhang H
J Neurointerv Surg 2019 Apr;11(4):411-415. Epub 2018 Sep 27 doi: 10.1136/neurintsurg-2018-014184. PMID: 30262658
Chen J, Yang M, Wu P, Li T, Ning X, Peng S, Wang J, Qi N, Gong K
Urol Int 2018;100(3):368-374. Epub 2016 Jan 22 doi: 10.1159/000443700. PMID: 26795724
Al-Jaishi AA, Liu AR, Lok CE, Zhang JC, Moist LM
J Am Soc Nephrol 2017 Jun;28(6):1839-1850. Epub 2016 Dec 28 doi: 10.1681/ASN.2016040412. PMID: 28031406Free PMC Article
Cronin EM, Brunner MP, Tan CD, Rene Rodriguez E, Rickard J, Martin DO, Wazni OM, Tarakji KG, Wilkoff BL, Baranowski BJ
Heart Rhythm 2014 Mar;11(3):404-11. Epub 2013 Nov 28 doi: 10.1016/j.hrthm.2013.11.024. PMID: 24291414
Kincaid PK, Duckwiler GR, Gobin YP, Viñuela F
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Clinical prediction guides

Li J, Ji Z, Yu J, Ren J, Yang F, Bian L, Zhi X, Li G, Zhang H
Stroke Vasc Neurol 2023 Aug;8(4):292-300. Epub 2023 Jan 6 doi: 10.1136/svn-2022-001979. PMID: 36609545Free PMC Article
Şahin S, Tokgöz B, Demir G
Pain Manag Nurs 2021 Aug;22(4):509-515. Epub 2021 Feb 25 doi: 10.1016/j.pmn.2021.01.009. PMID: 33640257
Bulbul E, Enc N
J Vasc Access 2021 Mar;22(2):178-183. Epub 2020 Jun 18 doi: 10.1177/1129729820933753. PMID: 32552344
Lagman C, Chung LK, Chitale RV, Yang I
World Neurosurg 2017 Oct;106:206-210. Epub 2017 Jun 30 doi: 10.1016/j.wneu.2017.06.141. PMID: 28673891
Muir CA, Kotwal SS, Hawley CM, Polkinghorne K, Gallagher MP, Snelling P, Jardine MJ
Clin J Am Soc Nephrol 2014 Jan;9(1):110-9. Epub 2013 Dec 26 doi: 10.2215/CJN.03930413. PMID: 24370768Free PMC Article

Recent systematic reviews

Almeida BM, Moreno DH, Vasconcelos V, Cacione DG
Cochrane Database Syst Rev 2022 Apr 1;4(4):CD013554. doi: 10.1002/14651858.CD013554.pub2. PMID: 35363884Free PMC Article
Rosen A, Chan WV, Matelski J, Walsh C, Murji A
Fertil Steril 2021 Oct;116(4):1107-1116. Epub 2021 Jun 12 doi: 10.1016/j.fertnstert.2021.05.095. PMID: 34130801
Bylsma LC, Gage SM, Reichert H, Dahl SLM, Lawson JH
Eur J Vasc Endovasc Surg 2017 Oct;54(4):513-522. Epub 2017 Aug 23 doi: 10.1016/j.ejvs.2017.06.024. PMID: 28843984
Al-Jaishi AA, Liu AR, Lok CE, Zhang JC, Moist LM
J Am Soc Nephrol 2017 Jun;28(6):1839-1850. Epub 2016 Dec 28 doi: 10.1681/ASN.2016040412. PMID: 28031406Free PMC Article
Ravani P, Palmer SC, Oliver MJ, Quinn RR, MacRae JM, Tai DJ, Pannu NI, Thomas C, Hemmelgarn BR, Craig JC, Manns B, Tonelli M, Strippoli GF, James MT
J Am Soc Nephrol 2013 Feb;24(3):465-73. Epub 2013 Feb 21 doi: 10.1681/ASN.2012070643. PMID: 23431075Free PMC Article

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