Embolization of a Mesenteric Arteriovenous Fistula

Huang, Ivan Kuang Hsin; Ameli-Renani, Seyed; Ratnam, Lakshmi; Morgan, Robert

doi:10.1016/j.jvir.2017.05.023

Cited by 2 publications

(4 citation statements)

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“…It can be performed through a transarterial, transvenous, or combined approach, and typically involves covered stents or coil embolization for fistula closure (Shintani et al, 2011;Wu et al, 2008;Kato et al, 1993;An et al, 2013;Zhao et al, 2018;Landi et al, 2015;Jargiełło et al, 2019;Zhao et al, 2014;Farshidmehr et al, 2019;Howley et al, 2019;Yamaguchi et al, 2018;Wang et al, 2016). Vascular plugs, as described in the present case, also appear to be an effective option, with potentially less risk for migration into the portal venous system than coils (Rimon et al, 2008;Huang et al, 2018). Other potential complications of endovascular SMAVF closure are portal vein thrombosis and mesenteric ischemia (Landi et al, 2015).…”

Section: Discussionmentioning

confidence: 81%

“…This rare vascular anomaly often presents with sequelae of portal hypertension, heart failure, or mesenteric ischemia (Kato et al, 1993). Although widely variable, common signs and symptoms of SMAVF include abdominal pain, diarrhea, upper or lower gastrointestinal bleeding, ascites, and anemia (Shintani et al, 2011;Wu et al, 2008;Rimon et al, 2008;Kato et al, 1993;An et al, 2013;Zhao et al, 2018;Landi et al, 2015;Huang et al, 2018;Jargiełło et al, 2019;Zhao et al, 2014;Farshidmehr et al, 2019). The most consistent specific physical exam finding is an abdominal bruit (Kato et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

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Superior mesenteric arteriovenous fistula embolization with a vascular plug for upper gastrointestinal hemorrhage: a case report

et al. 2022

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Background Superior mesenteric arteriovenous fistula is a rare vascular anomaly often presenting with sequelae of portal hypertension, heart failure, or mesenteric ischemia. This report describes a patient with a previously unidentified superior mesenteric arteriovenous fistula who presented with variceal bleeding, thought to be the leading cause of mortality associated with this condition. Although this patient was initially referred for a transjugular intrahepatic portosystemic shunt procedure, following a thorough review of her clinical history and imaging, she instead underwent embolization of the arteriovenous fistula likely responsible for her symptoms. Case Presentation A 75-year-old woman with a past surgical history of extensive small bowel resection presented with active variceal bleeding requiring transfusions. She was referred to vascular and interventional radiology for transjugular intrahepatic portosystemic shunt procedure; however, her clinical presentation was inconsistent with cirrhosis. This prompted a further review of her imaging, which identified a superior mesenteric arteriovenous fistula as the probable etiology of her varices. This fistula was subsequently embolized with a vascular plug and follow-up upper endoscopy at 1-month demonstrated complete resolution of her varices. Conclusions This report highlights a potential etiology of variceal bleeding in the acutely ill patient. Through a thorough consultation, the patient described here was able to avoid a procedure with the potential to cause catastrophic consequences, and instead receive the appropriate treatment for an uncommon condition. Level of Evidence Level 4, Case Report.

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Superior mesenteric arteriovenous fistula embolization with a vascular plug for upper gastrointestinal hemorrhage: a case report

et al. 2022

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show abstract

“…It can be performed through a transarterial, transvenous, or combined approach, and typically involves covered stents or coil embolization for stula closure [6,8]. Vascular plugs also appear to be an effective option, with less risk for migration into the portal venous system [3,7]. Other potential complications of endovascular SMAVF closure are portal vein thrombosis and mesenteric ischemia [8].…”

Section: Discussionmentioning

confidence: 99%

“…This rare vascular anomaly often presents with sequelae of portal hypertension, heart failure, or mesenteric ischemia [4]. Although widely variable, common signs and symptoms of SMAVF include abdominal pain, diarrhea, upper or lower gastrointestinal bleeding, ascites, and anemia [1][2][3][4][5][6][7][8]. The most consistent speci c physical exam nding is an abdominal bruit [4].…”

Section: Introductionmentioning

confidence: 99%

Embolization of a Superior Mesenteric Arteriovenous Fistula Identified During Consultation for a Transjugular Intrahepatic Portosystemic Shunt Procedure: A Case Report

Shinagawa

Billah

Kansagra

et al. 2021

Preprint

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Superior mesenteric arteriovenous fistula is a rare vascular anomaly often presenting with sequelae of portal hypertension, heart failure, or mesenteric ischemia. This report describes a 75-year-old woman with a history of extensive small bowel resection who presented with variceal bleeding. She was referred to vascular and interventional radiology for a transjugular intrahepatic portosystemic shunt procedure; however, her history was inconsistent with cirrhosis. This prompted further review of her imaging, which identified a superior mesenteric arteriovenous fistula as the probable etiology of her varices. This was subsequently embolized with a vascular plug and follow-up upper endoscopy at 1-month demonstrated complete resolution of her varices. This patient was able to avoid a procedure with potentially catastrophic consequences, highlighting the necessity of comprehensive consultations by interventional physicians. Level of Evidence: Level 4, Case Report.

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Embolization of a Mesenteric Arteriovenous Fistula

Cited by 2 publications

References 0 publications

Superior mesenteric arteriovenous fistula embolization with a vascular plug for upper gastrointestinal hemorrhage: a case report

Superior mesenteric arteriovenous fistula embolization with a vascular plug for upper gastrointestinal hemorrhage: a case report

Embolization of a Superior Mesenteric Arteriovenous Fistula Identified During Consultation for a Transjugular Intrahepatic Portosystemic Shunt Procedure: A Case Report

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