Vascular Pathology Flashcards
Define: Anomalous connection between an artery and vein.
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Can occur between any artery and vein.
Arteriovenous Fistulas
what is the etiology of an av fistula?
Congenital or Acquired
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Congenital: born with and can occur in many areas: Hemangioma, Lungs, Head and Neck and Brain…
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Acquired: typically associated with trauma, tumor or iatrogenic: GSW, Malignancy, Dialysis Fistula or Post Bx. complication
what symptoms may be present w/ an AV fistula?
Site dependent
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Presence of bruit or thrill associated with dilated pulsatile mass
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Low back, abdominal pain
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Swelling of LE
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Hypertension
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Cardiomegaly – why?
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Heart failure – why?
what do you u see w US when lookin at an avf?
Difficult to see on 2D
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Doppler diagnosis is key
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Arterial side, above fistula
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How will flow resistance be?
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Venous side, above fistula
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How will flow volume be?
Arterial side
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Increased diastolic flow in artery proximal to fistula
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Reverts to normal diastolic flow distal to fistula
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Venous side
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Pulsatile venous flow
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Irregular waveform and high velocities
what type of Inferior Vena Cava Abnormalities are there?
what are their etiologies?
Thrombosis – Most common intraluminal finding
Partial or complete. Life threatening
Multiple etiologies: Renal failure, Umbilical lines
Intracaval lines, Thrombus extension from DVT in eg, Renal v, Hepatic v
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Tumor invasion
Primary tumors of IVC are rare
Extension of renal cell, more often on Rt.
Appearance similar to thrombus, may see arterial flow within tumor
what can happen w/ a dialated ivc?
•Rt. ventricular failure
Pulmonary HTN
Heart disease
Displacement - Compression
Mass effect
Can give a clue to an un-diagnosed disease process i.e.lymphadenopathy
These are 3 different pt. with IVC thrombus. what are their differences?
what is this demonstrating?
With tumor invasion on any venous vessel, the tumor itself will have arterial flow within.
clot or tumor of the PV?
tumor
describe what you see
color flow w/i the tumor. spectral deomonstrates arterial flow. the HA can be seen above baseline.
what clinical signs of IVC thrombosis/tumor?
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Asymptomatic
LE edema
Symptoms of Cancer weight loss
know the difference b/t clot and cancer. clot h/o birth control, prior dvt, etc cancer - weight loss.
what is Heparin therapy used for?
Thrombolysis?
IVC filters?
Stop clot from growing
To dissolve clot
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To prevent pulmonary emboli (PE)
Patients who have recurrent
venous thrombosis
–Location
•Infrarenal IVC
–To prevent RV thrombosis
placed below the renal veins b/c the stuff that comes out of the renal veins is a natural thrombolysis
what are these?
ivc filters
what types of ivc congenital anomalies are there?
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Associated with polysplenia or asplenia
if there is something going on with the ivc, look at the spleen!!! or if you notice lots of spleens or a missing spleen, check the ivc
