Arteriovenous fistula of a colic branch of the superior mesenteric artery: endovascular therapy

Transarterial embolization of secondary inferior and superior mesenteric artery arteriovenous fistulas: a systematic review

Background

Acquired arteriovenous fistula are rare complications of a piercing injury, including a gunshot or knife injury, the rupture of a preexisting aneurysm into a neighboring vein, or a complication of arterial catheterization or abdominal surgical techniques, most often colonic resection. Our aim was to develop an online systematic review of the literature to determine all documented incidents of endovascular embolization of secondary mesenteric Arteriovenous Fistula, spanning key databases as well as pertinent publications, from 1982 to 2019. Our case was included as well. The primary objectives were technical success and death; the secondary outcomes were the frequency of complications and the advice of the operators.

Main body

Forty articles, comprising 41 patients, including our own, were reviewed. The superior mesenteric vessels are the most commonly affected by fistulas. Endovascularembolization was used in 80% of the cases. 100% of the patients had technical success. The intraoperative death rate was 0%, with a 90-day mortality rate of 8%, half of which was unrelated to the original pathology. More than 60% of patients who underwent successful treatments had no severe problems. All others had uneventful recoveries, with only 12% experiencing mild problems that were managed conservatively.

Conclusions

The majority of authors supported this therapeutic approach thereby making endovascular glue embolization the treatment of choice for superior mesenteric arteriovenous fistula and inferior mesenteric arteriovenous fistula in high risk patients and in patients with multiple co-morbidities.

Mesenteric Lymph Node Hamartoma (Castleman's Disease) in Association with Superior Mesenteric Arteriovenous Fistula

We present a case of 21-year-old female patient with history of pain abdomen and abdominal distension. The patient also had oedema of the limbs, puffiness of the face, pallor and palpable mass in the abdomen. Ultrasonography of the abdomen and computed tomographic angiogram was done and it showed presence of vascular mass along with arteriovenous malformation in the mesentry of small gut between distal branches of superior mesenteric artery and vein. Surgical excision of the mass with ligation and division of the arteriovenous malformation was done through midline laparotomy. Histopathological examination was consistent with the diagnosis of Castleman's disease. The Patient recovered well and was discharged after seven days.

Superior mesenteric arteriovenous fistula: imaging findings and endovascular treatment

Arteriovenous fistulae (AVF) of the superior mesenteric vasculature are rarely encountered. We present a case of an iatrogenic superior mesenteric AVF following subtotal colectomy, which was successfully treated with coil embolization. Cross-sectional imaging and angiographic findings are reviewed along with the options for endovascular therapy.

Transcatheter coil embolization of an iatrogenic superior mesenteric arteriovenous fistula: report of a case

A 37-year-old male patient presented with abdominal pain and diarrhea. Computed tomography showed a large superior mesenteric vein aneurysm. The patient had a history of Crohn's disease and underwent an ileocecal resection 7 years previously. A selective angiogram of the superior mesenteric artery revealed that a dilated branch of this artery fed directly into the superior mesenteric vein. The iatrogenic superior mesenteric arteriovenous fistula was successfully closed by transarterial coil embolization. Successful endovascular treatment for a superior mesenteric arteriovenous fistula has been recently reported; however, the complications of this new modality are not well understood. We herein review the current literature and discuss endovascular treatment.