Affiliations: [a] Clinic and Policlinic of Diagnostic Radiology, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| [b] Department of Radiology, Asklepios Klinik Weissenfels, Weissenfels, Germany
| [c] Clinic and Policlinic of Radiology, Ludwigs-Maximilians University Munich, Munich, Germany
| [d] Clinic for Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
Correspondence:
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Corresponding author: B. Cucuruz, Department of Radiology, University Hospital Halle, Halle, Germany. E-mail: Beatrix.cucuruz@uk-halle.de.
Abstract: BACKGROUND:Venous malformations tend to retain their slow-flow behavior, even in progressive disease or regression following therapy. OBJECTIVE:The aim of this study is to analyze the development of acquired hemodynamic relevant arterio-venous fistulae in patients with slow-flow malformations. METHODS:This study is a retrospective analysis based on a consecutive local registry at a tertiary care Interdisciplinary Center for Vascular Anomalies. Patients with venous malformations and development of secondary arterio-venous fistulae were included. Indications for therapy of the vascular malformation were based on patients’ symptoms and complications. The following endpoints were of clinical interest and were assessed: origin of development of arteriovenous fistula, development of secondary comorbidities as a result of the vascular malformation. For analysis we focused on descriptive statistics. RESULTS:Out of 1213 consecutive patients with vascular malformations, in 6 patients perfusion changed from slow flow to arterio-venous fast-flow patterns. Four patients developed the fistula after local trauma in the area of the malformation, the other 2 patients developed the fistula due to progression of the disease and recurrent thrombophlebitis. These 2 patients had no trauma or interventions at the time of arterio-venous fistula development. CONCLUSIONS:Acquired arterio-venous fast-flow fistula in patients with slow flow vascular malformation is very rare and might be a result of local trauma or the progression of the disease with recurrent thrombophlebitis. Specific evidence-based treatment options for these patients do not exist.
