What is the pathogenesis of arteriovenous fistula?
Aug 06, 2021
Source: Cainiu Health
Dr. Song Qiang
Introduction
The pathogenesis involves arterial blood entering the accompanying vein through an abnormal channel, leading to vascular lesions at the fistula site, alterations in local circulation around the fistula, and systemic hemodynamic changes. Arteriovenous fistulas (AVFs) are generally classified as either congenital or acquired—typically resulting from trauma. AVFs are primarily categorized into two types: acute and chronic arteriovenous fistulas.
An arteriovenous (AV) fistula, as the name implies, is an abnormal connection between an artery and a vein. Its pathophysiology involves arterial blood bypassing its normal route and flowing directly into an adjacent vein. This can lead to localized vascular changes at the fistula site, alterations in regional circulation surrounding the fistula, and systemic hemodynamic disturbances.
AV fistulas are generally classified as either congenital or acquired—most commonly due to trauma. Patients with AV fistulas often present with varicose veins in the surrounding area, elevated local skin temperature, hyperpigmentation, ulceration, and audible bruits or palpable thrill at the fistula site. In advanced stages, cardiac enlargement and heart failure may develop. AV fistulas are primarily categorized into two types: acute and chronic. The fundamental underlying mechanism in both types remains the presence of an abnormal communication between an artery and a vein.
