関: arteriovenous communication

WordNet

a natural or surgical joining of parts or branches of tubular structures so as to make or become continuous (同)inosculation
connecting an artery to a vein; "an arteriovenous fistula"

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/10 12:51:59」(JST)

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A circulatory anastomosis is a connection (an anastomosis) between two blood vessels, such as between arteries (arterio-arterial anastomosis), between veins (veno-venous anastomosis) or between an artery and a vein (arterio-venous anastomosis). Anastomoses between arteries and between veins result in a multitude of arteries and veins, respectively, serving the same volume of tissue. Such anastomoses occur normally in the body in the circulatory system, serving as backup routes for blood to flow if one link is blocked or otherwise compromised, but may also occur pathologically.^[1]

Physiologic

Arterio-arterial anastomoses include actual (e.g., palmar and plantar arches) and potential varieties (e.g., coronary arteries and cortical branch of cerebral arteries).

There are many examples of normal arterio-arterial anastomoses in the body. Clinically important examples include:

Circle of Willis (in the brain)
Coronary: anterior interventricular artery and posterior interventricular artery of the heart
Scapular anastomosis (for the subclavian vessels)
Joint anastomoses: Almost all joints receive anastomotic blood supply from more than one source.
- Shoulder (and circumflex humeral)
- Elbow (see blood supply of elbow)
- Hip (and circumflex iliac; see also cruciate anastomosis)
- Knee (and genicular arteries; see also patellar network)
- Ankle
Abdominal anastomoses
- Marginal artery of the colon
Pelvic anastomoses
Hand - palmar arch, superficial palmar arch and deep palmar arch
Foot - plantar arch

Coronary

Surgical intervention

Coronary anastomoses are a clinically vital subject: the coronary anastomosis is the blood supply to the heart. The coronary arteries are vulnerable to arteriosclerosis and other effects. Inadequate supply to the heart will lead to chest pains (angina) or a heart attack (myocardial infarction). These can be ameliorated by surgical intervention to create a bypass using the anastomosis technique.

Naturally occurring

Coronary anastomoses are anatomically present though functionally obsolete. There was some suggestion that they may be helpful if a problem develops slowly over time (this will need to be verified) but in the case of the pathogenesis of CHD they do not provide a sufficient blood flow to prevent infarction.

There are anastomoses between the Circumflex and right coronary arteries and between the anterior and posterior inter-ventricular arteries. In the normal heart these anastomoses are non-functional.

Arterio-venous

Superficial arterio-venous anastomoses open when the body reaches a high temperature, and enable the body to cool itself. As warm arterial blood passes close to the surface it will decrease in temperature. This occurs together with sweating.^{[citation needed]}

Pathologic

Pathological anastomoses result from trauma or disease and may involve veins, arteries, or intestines. These are usually referred to as fistulas. In the cases of veins or arteries, traumatic fistulas usually occur between artery and vein. Traumatic intestinal fistulas usually occur between two loops of intestine (enetero-enteric fistula) or intestine and skin (enterocutaneous fistula). Portacaval anastomosis, by contrast, is a veno-venous anastomosis between a vein of the portal circulation and a vein of the systemic circulation, which allows blood to bypass the liver in patients with portal hypertension, often resulting in hemorrhoids, esophageal varices, or caput medusae.

Circulatory anastomoses between monochorionic twins may result in twin-to-twin transfusion syndrome.^[2]

References

^ Johnson, DR. "Introductory Anatomy: Circulatory System and Blood". Archived from the original on 21 February 2011. Retrieved 21 February 2011.
^ Shulman, Lee S.; Vugt, John M. G. van (2006). Prenatal medicine. Washington, DC: Taylor & Francis. pp. Page 447. ISBN 0-8247-2844-0.

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1. 新たに形成された血液透析動静脈瘻の成熟および評価maturation and evaluation of the newly created hemodialysis arteriovenous fistula [show details]
…can usually be detected by palpating the AV fistula. The thrill that is palpable over the arteriovenous anastomosis should disappear when the outflow vein is manually occluded more proximally due to cessation …
2. 治療抵抗性高血圧の治療treatment of resistant hypertension [show details]
…include electrical stimulation of the carotid sinus baroreceptors and creation of a central arteriovenous anastomosis. Stimulation of the carotid sinus baroreflex system, or baroreflex activation therapy (BAT) …
3. 血液透析をするための動静脈瘻の作成とその合併症arteriovenous graft creation for hemodialysis and its complications [show details]
…arterial stenosis or progressive arterial occlusive disease in the extremity distal to the arteriovenous anastomosis . If surgical intervention is required and preservation of the AV graft is a high priority …
4. 内シャント側の狭窄部位に行う経皮的血管形成術の手技techniques for angioplasty of the arteriovenous hemodialysis access [show details]
… vein stenosis. Two special areas that should be evaluated separately are the venous anastomosis of an arteriovenous (AV) graft and lesions of the cephalic arch. These two areas are somewhat unique in their …
5. 血液透析動静脈瘻における初期機能不全primary failure of the hemodialysis arteriovenous fistula [show details]
…stenosis were juxta-anastomotic venous segment (65.2 percent), venous outflow (41.1 percent), arteriovenous anastomosis (30.5 percent), native artery (5.7 percent), distal outflow (9.2 percent), and central vein …

English Journal

Arteriovenous Hybrid Graft with Outflow in the Proximal Axillary Vein.

Murga AG1, Chiriano J1, Kiang SC1, Patel S1, Bianchi C1, Abou-Zamzam AM1, Teruya TH2.
Annals of vascular surgery.Ann Vasc Surg.2017 Jul;42:39-44. doi: 10.1016/j.avsg.2017.02.002. Epub 2017 Mar 24.
PMID 28344184

Placement of Upper Extremity Arteriovenous Access in Patients with Central Venous Occlusions: A Novel Technique.

Murga AG1, Chiriano JT1, Bianchi C1, Sheng N1, Patel S1, Abou-Zamzam AM Jr1, Teruya TH2.
Annals of vascular surgery.Ann Vasc Surg.2017 Jul;42:317-321. doi: 10.1016/j.avsg.2016.11.008. Epub 2017 Mar 8.
PMID 28286186