Images of the month 1: Ischaemic stroke due to pulmonary arteriovenous fistula (2024)

FAQs

Can a fistula cause a stroke? ›

Depending on where the fistula is, it may lead to a stroke. Leg pain due to lack of blood flow (claudication). An arteriovenous fistula can block blood flow to muscles, causing leg pain.

A pulmonary arteriovenous fistula is an abnormal blood vessel that creates a potentially troublesome connection between a vein and an artery in the lung. It acts as a detour, sidestepping the normal route the blood is supposed to take. If a patient has symptoms or problems, medical attention is essential.

The second most common complaint is dyspnea on exertion, which is more common in patients with large or multiple pulmonary AVMs. Hemoptysis and rarely massive hemoptysis can occur. Less common complaints include chest pain, cough, migraine, headaches, dizziness, dysarthria, syncope, vertigo, and diplopia.

Causes. Pulmonary arteriovenous fistulas are usually the result of abnormal development of the blood vessels of the lung. Most occur in people with hereditary hemorrhagic telangiectasia (HHT). These people often have abnormal blood vessels in many other parts of the body.

The most common type of AVF was radiocephalic fistula (RCF). The most common complication associated with the patients with AVF was ischemic neuropathy (29.6%).

These holes typically spread the infection that creates them, and life-threatening conditions such as peritonitis (inflammation of the lining of the abdomen) may occur. A fistula is an abnormal connection between an organ, vessel, or intestine and another organ, vessel or intestine, or the skin.

Previous studies reported a wide range of AVF survival rates: 68% to 92% for one-year survival, 57% to 85% for two-year survival, and 4% to 71% for five-year survival.

Pulmonary arteriovenous fistula is an abnormal connection between an artery and vein in the lungs. As a result, blood passes through the lungs without receiving enough oxygen.

Arteriovenous fistulas can take between 6-12 weeks to mature and arteriovenous grafts can generally be used 2-3 weeks after surgery.

Survival is therefore significantly higher than the International Society for Heart Lung Transplantation 2016 median survival figures across all pathologies of 5.7 years for adults, 5.4 years for children⁶⁷](p<0.01) and 10-year survival rates (48%) reported at one UK transplant centre⁶⁸ (p<0.01).

How does pulmonary AVM cause stroke? ›

Pulmonary arteriovenous malformations may serve as a conduit for deep vein thrombosis to cerebral circulation, thereby causing an acute ischemic stroke.

PAVM is a rare disorder with an incidence of 2–3 per 1000000 population [1].

Most pulmonary arteriovenous malformations (AVMs) are congenital in origin and result when the blood vessels of the lung do not develop normally. There have been reports of acquired lesions, purportedly related to infections, neoplasma, or trauma. AVMs may be single or multiple. They are more common in the lower lobe.

Causes of Arteriovenous Fistulas

Acquired arteriovenous fistulas often occur when there is trauma to the body's tissue, such as a stabbing wound or gunshot injury. Some patients with late-stage kidney disease may have a fistula surgically created to help with dialysis.

BPFs do not typically spontaneously undergo closure and almost always require some surgical or bronchoscopic intervention. All patients with a BPF should have a chest tube placed to drain air. In cases of an empyema, infected pleural fluid should be drained, and antibiotics should be initiated.

Fistulas may result in malnutrition and dehydration, depending on their location in the intestine. They may also cause skin problems and infection.

Pial or cerebral arteriovenous fistulas occur in the brain. A large one can cause heart failure at or even before birth. Smaller ones can damage the brain around the fistula because it diverts blood flow away from the brain tissue and into the draining vein.

Sepsis (also known as blood poisoning or septicaemia) is a potentially life-threatening condition that can occur in people with infections. Sepsis is uncommon in people with simple fistulas, but can occur in more complex cases or where there is a large collection of pus (an abscess) that fails to discharge.