Prenatal diagnosis and treatment of intrahepatic arteriovenous fistulas: case reports and the literature review

Demirci, Oya; Celayir, Ayşenur Cerrah

doi:10.1080/14767058.2020.1731466

Cited by 9 publications

(12 citation statements)

References 22 publications

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“…HAVMs are rare congenital lesions consisting of hepatic artery-portal vein fistula and hepatic artery-hepatic venous malformation. There have been only 8 reports of HAVMs in fetuses with typical imaging in ultrasonography in the previous literature, [ 3 , 4 ] but no MRI imaging data were provided. HAVMs are reported to be associated with HHT, which is inherited as an autosomal dominant disease caused by mutations in ENG, ACVRL1, or SMAD-4 genes.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhage and necrosis of the liver caused by hepatic arteriovenous malformations in a fetus: A case report

Bian¹,

Yuan²,

Yuan³

2023

Medicine

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Rationale: Hepatic arteriovenous malformations (HAVMs) are a rare disorder reported in association with hereditary hemorrhagic telangiectasia (HHT), known as Rendu-Osler-Weber syndrome. HAVMs are usually detected in adulthood. Patient concerns: A 29-year-old pregnant woman underwent a routine prenatal examination at 37 weeks of pregnancy. Diagnosis and interventions: There were fetal liver anomalies detected by prenatal ultrasonography and were managed. Furthermore, a hepatic mass was detected and was subsequently analyzed by fetal magnetic resonance imaging. There were no typical imaging findings in this case which was once misdiagnosed as a hepatoblastoma. Outcomes: Considering the massive hepatic lesion, labor induction was performed on a pregnant woman to avoid adverse maternal and fetal outcomes. Histopathological examination confirmed the diagnosis of HAVMs. Lesions detected by imaging were determined to be hemorrhagic and necrotic. Lessons: Prenatal hepatic hemorrhage and necrosis due to an arteriovenous malformation are rare. The authors describe their observations and results.

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Section: Discussionmentioning

confidence: 99%

Hemorrhage and necrosis of the liver caused by hepatic arteriovenous malformations in a fetus: A case report

Bian¹,

Yuan²,

Yuan³

2023

Medicine

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“…Prenatal treatment including propranolol or corticosteroids may be helpful, as described in one case report. 24 Follow-up examinations should be carried out depending on size of the vascular malformation, extent of the perfusion, and signs of high cardiac output failure (severe cardiomegaly, AV valve insufficiency, and hydrops fetalis, respectively) in order to identify progression and to time delivery and therapeutic intervention. Acute prenatal deterioration from time of diagnosis is not generally expected and should be considered when initiating corticosteroid prophylaxis or timing delivery, as these lesions are non-proliferating vascular anomalies that grow proportionally to fetal weight.…”

Section: Discussionmentioning

confidence: 99%

“…Early prenatal diagnosis of intrahepatic AVM is important as it might change management and outcome of affected fetuses. Prenatal treatment including propranolol or corticosteroids may be helpful, as described in one case report 24 . Follow‐up examinations should be carried out depending on size of the vascular malformation, extent of the perfusion, and signs of high cardiac output failure (severe cardiomegaly, AV valve insufficiency, and hydrops fetalis, respectively) in order to identify progression and to time delivery and therapeutic intervention.…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis and management of a giant intrahepatic arteriovenous malformation—Sonographic findings, clinical implications, and treatment

Walter

Calite

Müller

et al. 2022

Clinical Case Reports

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“…Although the radio-cephalic AVF is the recommended initial access for hemodialysis, the radial artery at the volar wrist and the brachial artery at the antecubital fossa and medial upper arm are usual anatomical locations for stula development (4). In some of the cases, lower extremity AVF is approached secondary to upper extremity AVF failure.…”

Section: Introductionmentioning

confidence: 99%

“…The ideal venous access would provide enough blood for the dialysis, be more durable, and have a low rate of complications (7). Complications such as stenosis, aneurysm, infection, and bleeding prevent AVF patency and lead to AVF de ciency (4,5). The incidence of AVF de ciency is increasing accordingly like cardiovascular disorder (7).…”

Section: Introductionmentioning

confidence: 99%

Haemodialysis Patients with arteriovenous fistula: Knowledge, attitude, and practice in Patient Visiting Tertiary Centre of Nepal pre and post-operatively.

Dev,

Sah,

Yadav

et al. 2023

Preprint

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Introduction Chronic kidney disease (CKD) affects over 800 million people globally, making it the leading cause of mortality in the 21st century. Hemodialysis, a procedure that filters water and waste from the blood, helps regulate vital blood minerals and blood pressure. Vascular access is crucial for hemodialysis, including arteriovenous fistulas (AVFs), arteriovenous grafts, and central venous catheters. The ideal venous access should provide enough blood for dialysis, be durable, and have a low rate of complications. AVF deficiency can lead to cardiovascular disorders, so it is important to ensure its patency and maintenance. Patient education and nurse care can help maintain AVF patency for a long time. This study aimed to examine AVF perceptions among hemodialysis patients in terms of knowledge and attitude. Method A descriptive cross-sectional study was conducted at the Maharagjung Medical Campus Haemodialysis Unit and Cardiovascular Surgery to assess knowledge, attitude, and practice toward arteriovenous fistula (AVF) care. The study included patients with CKD-V or ESRD, aged 18 years or <85 years, with radio-cephalic, brachiobasilic, or brachiocephalic fistulae created. The study was approved by the Tribhuvan University Institute of Medicine Institutional Review Board. Patients were interviewed before and after surgery using a structured questionnaire. The study used Naveed Rashid's knowledge score system, with 40% as poor knowledge, 40-70% as adequate knowledge, and over 70% as good knowledge out of a total score of 12. The data was processed using SPSS, and the chi-square test was applied to determine the relationship between knowledge, attitude, and practice of AVF care. A p-value of 0.05 was considered significant. Result A study of 173 patients with AVFs found that most had poor knowledge about AVF self-care, with 98.8% having poor knowledge preoperatively and 98.3% having good knowledge postoperatively. The study found a significant correlation between knowledge, sex, and socioeconomic status postoperatively, but not between knowledge and age group. Patients from upper and upper middle classes had better knowledge acquisition than those from lower middle classes. Attitude towards fistula care was high, with 99% of participants agreeing that it is beneficial preoperatively and postoperatively. However, 89.6% of participants were only satisfied with their decision to form a fistula over time. Initially, 97.1% of participants were motivated toward AVC care, but by the 6th week's follow-up, 78.0% were only motivated towards AVF care. Most patients practiced weight-bearing prevention, cleaning, and drying, but fewer practiced daily verification of fluid thrill, exercise with malleable balls, and avoiding blood pressure from the fistula hand. Discussion A study on hemodialysis via AVF access site found that most patients had poor knowledge of AVF care preoperatively and good knowledge postoperatively, indicating good delivery of information and knowledge at the hospital. The study also found that acquired knowledge correlated with socioeconomic status and sex postoperatively. Attitude towards fistula care was high, with 99% of participants agreeing that it is beneficial preoperatively and postoperatively. However, 89.6% of participants were only satisfied with their decision to form a fistula over time. Initially, 97.1% of participants were motivated toward AVC care, but by the 6th week's follow-up, 78.0% were only motivated towards AVF care. Despite poor knowledge before surgery, participants after counseling had good practice in all areas of AVF care. Avoidance behaviour was observed in exercising with malleable objects, daily thrill checks, and blood pressure from the fistula hand. The study suggests that practice can be improved by proper health professional-patient relationships and proper, adequate, and regular counselling. Conclusion The study reveals that patients' preoperative knowledge of AVF care can be improved through proper counselling, with forgetfulness and decreased self-motivation being key reasons for not following specific areas. Regular, timely counselling is recommended for practical aspects.

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Prenatal diagnosis and treatment of intrahepatic arteriovenous fistulas: case reports and the literature review

Cited by 9 publications

References 22 publications

Hemorrhage and necrosis of the liver caused by hepatic arteriovenous malformations in a fetus: A case report

Hemorrhage and necrosis of the liver caused by hepatic arteriovenous malformations in a fetus: A case report

Prenatal diagnosis and management of a giant intrahepatic arteriovenous malformation—Sonographic findings, clinical implications, and treatment

Haemodialysis Patients with arteriovenous fistula: Knowledge, attitude, and practice in Patient Visiting Tertiary Centre of Nepal pre and post-operatively.

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