arteriavais

Arteriavais is not a widely used term in contemporary medical literature. When encountered, it is often a misspelling or umbrella label for abnormal direct connections between arteries and veins, which more precisely are described as arteriovenous fistulas (AVFs) or arteriovenous malformations (AVMs). These vascular shunts bypass the capillary beds and can be congenital or acquired, with peripheral, cerebral, or visceral locations.

Definition and types. An arteriovenous shunt is an abnormal conduit linking a high-pressure artery to a vein. AVMs are congenital collections of tangled vessels with feeding arteries and draining veins, while AVFs are direct artery-to-vein connections. Acquired AVFs can result from trauma, surgery, or medical instrumentation and may occur at various sites, including the limbs or the head and neck. Peripheral AVFs used for hemodialysis access are a common clinical example.

Pathophysiology. The direct shunt creates high-flow, low-resistance channels that can cause venous dilation, steal phenomena (reduced perfusion of surrounding tissues), heart strain from increased preload, and, in the brain, potential rupture and hemorrhage.

Clinical presentation. Symptoms depend on location: a vascular bruit or pulsatile mass and swelling for peripheral AVFs; skin changes or limb ischemia; cerebral AVMs may present with headaches, seizures, or intracranial hemorrhage. Dialysis AVFs are identified by a palpable thrill and audible bruit.

Diagnosis. Doppler ultrasound is typically the first test, followed by computed tomography (CT) or magnetic resonance (MR) angiography for detailed anatomy. Digital subtraction angiography is often the gold standard for definitive assessment and treatment planning.

Management. Treatment aims to reduce shunt flow and prevent complications. Peripheral AVFs for dialysis are surgically created or managed with endovascular techniques. Cerebral AVMs/AVFs may be treated with embolization, microsurgical resection, or stereotactic radiosurgery, depending on size, location, and patient factors.

Prognosis. Outcomes vary widely by location and treatment success. Complications include heart failure, rupture, hemorrhage, and infection. See also arteriovenous fistula, arteriovenous malformation, and arteriovenous shunt.