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Arteriovenous fistula: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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[Symptoms of arteriovenous fistula
Fistula can cause symptoms of arterial insufficiency (eg, limb ulceration due to decreased arterial blood flow, embolism or ischemia) or chronic venous insufficiency due to high blood pressure pressure on the damaged veins (eg, peripheral edema, varicose veins, stagnant pigmentation). If the fistula is located close to the surface, it can be palpated, the damaged area usually swells and becomes warmer than the rest of the skin, with bloating, and often the pulsation of the superficial veins. Above the fistula, palpation can be determined by trembling, and auscultatory detection of a prolonged purring noise with its amplification during systole. Sometimes, if a significant portion of the cardiac output is discharged through the fistula to the right heart, a heart failure with a high ejection develops .
Treatment of arteriovenous fistula
Congenital fistulas are not considered an indication for treatment unless serious complications develop (for example, lengthening one leg in a growing child). If necessary, percutaneous intravascular methods of treatment can be used, with placement of the obturating structures to close the fistula. Treatment is rarely completely satisfactory, but complications can be controlled. Acquired fistulas usually have a single major message, in which case surgical treatment is effective.