Noninvasive evaluation for congenital arteriovenous fistulas and malformation

Abstract

This chapter addresses the application of noninvasive vascular diagnostic laboratory (VDL) tests in diagnosing vascular anomalies containing arteriovenous fistulas (AVFs). These developmental defects can take several forms, diffuse microfistulas, groups of macrofistulas that involve major artery distributions, and more mature maturational defects, which tend to involve a single artery. Together these lesions are categorized by the Hamburg classification1 as predominantly AVFs, and constitute just over one-third of all vascular anomalies.2 AVFs can also be present in more complex mixed anomalies, e.g., in those that are predominantly venous. The VDL can provide much useful clinical decision-making information regarding peripheral AVFs. The diagnostic methods described here are all aimed at detecting AVFs and can even be used, albeit with some differences, in diagnosing acquired AVFs, those due to iatrogenic and other penetrating trauma. © 2007 Springer-Verlag London Limited.