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это?","markdown":"**Артериовенозная фистула** (артериовенозный свищ) — **аномальное соединение между артерией и веной**, не существующее в норме [1](https://ru.wikipedia.org/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0)[3](https://medcentr-Sochi.ru/flebolog/arteriovenoznaya-fistula.html)[8](https://sovamed.ru/zabolevaniya/arteriovenoznaya-fistula/). Обычно кровь течёт из артерий в капилляры, а затем в вены, но при артериовенозной фистуле кровь минует капилляры [1](https://ru.wikipedia.org/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0). \n\nОбычно фистула возникает в ногах, но может развиваться в любом месте тела [1](https://ru.wikipedia.org/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0).\n\n## Причины\nВозникновение фистулы связано с повреждением стенок сосудов под воздействием внешних или внутренних факторов [6](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_phlebology/arteriovenous-fistula). Некоторые причины: \n* **Врождённые аномалии** [6](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_phlebology/arteriovenous-fistula). Например, нарушения эмбриогенеза между 4 и 10 неделями гестации [6](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_phlebology/arteriovenous-fistula). \n* **Наследственные заболевания** (болезнь Рандю-Ослера-Вебера, синдром «голубого пузырчатого невуса») [6](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_phlebology/arteriovenous-fistula). \n* **Механические травмы** (колющие, огнестрельные ранения) [6](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_phlebology/arteriovenous-fistula). \n* **Инвазивные вмешательства** (катетеризация сосудов, биопсия паренхиматозных органов) [6](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_phlebology/arteriovenous-fistula). \n* **Хирургические манипуляции** (искусственно созданное соустье между артериальным руслом и венозной системой при терминальной почечной недостаточности для облегчения гемодиализа) [6](https://www.KrasotaiMedicina.ru/diseases/zabolevanija_phlebology/arteriovenous-fistula).\n\n## Симптомы\nПроявления артериовенозной фистулы зависят от её размера и расположения [3](https://medcentr-Sochi.ru/flebolog/arteriovenoznaya-fistula.html)[9](https://mrtpetrograd.ru/stati/zabolevaniya/svishch). Некоторые симптомы: \n* **Небольшие фистулы** — не вызывают негативных симптомов, в большинстве случаев обнаруживаются случайно [9](https://mrtpetrograd.ru/stati/zabolevaniya/svishch). \n* **В области подкожных фистул** — венозное расширение, локальное повышение температуры, отёчность и пульсация [9](https://mrtpetrograd.ru/stati/zabolevaniya/svishch). \n* **При крупных фистулах** — ишемия обширных участков тела и внутренних органов, падение артериального давления [9](https://mrtpetrograd.ru/stati/zabolevaniya/svishch). \n* **При спинальной локализации** — нарушение походки, онемение, боли в конечностях [9](https://mrtpetrograd.ru/stati/zabolevaniya/svishch).\n\n## Диагностика\nДля диагностики артериовенозной фистулы используют, например: \n* **УЗИ** (дуплексное сканирование с цветовым допплеровским картированием) [9](https://mrtpetrograd.ru/stati/zabolevaniya/svishch). \n* **Компьютерную ангиографию** — для визуализации локализации дефекта кровотока и его анатомических особенностей [10](https://analizy-Sochi.ru/bolezni-ven-i-limfouzlov/arteriovenoznaya-fistula.html). \n* **Магнитно-резонансную ангиографию** — для визуализации мягких тканей, определения расположения здоровых и патологических структур [10](https://analizy-Sochi.ru/bolezni-ven-i-limfouzlov/arteriovenoznaya-fistula.html).\n\n## Лечение\nЛечение артериовенозной фистулы зависит от её размера, места образования и общего состояния пациента [12](https://ru.ruwiki.ru/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0). Некоторые методы лечения: \n* **Эндоваскулярная эмболизация** — введение в центральную зону фистулы эмболизирующих веществ или устройств (клей, сосудистые пробки, стенты или съёмные баллоны) [12](https://ru.ruwiki.ru/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0). \n* **Микрохирургия** — удаление патологического сообщения с помощью нейрохирургического доступа под микроскопом [12](https://ru.ruwiki.ru/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0). \n* **Консервативное лечение** — для маленьких аномальных шунтов, которые не имеют существенного воздействия на кровоток, а также для доброкачественных фистул [12](https://ru.ruwiki.ru/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0). \n* **Хирургическое вмешательство** — крупные подкожные фистулы могут потребовать открытого хирургического доступа с последующей реконструкцией сосудов [12](https://ru.ruwiki.ru/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0).","linksData":[{"sourceId":1,"url":"https://ru.wikipedia.org/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0","shownUrl":"https://ru.wikipedia.org/wiki/%D0%90%D1%80%D1%82%D0%B5%D1%80%D0%B8%D0%BE%D0%B2%D0%B5%D0%BD%D0%BE%D0%B7%D0%BD%D0%B0%D1%8F_%D1%84%D0%B8%D1%81%D1%82%D1%83%D0%BB%D0%B0","title":"Артериовенозная фистула — Википедия","shortUrl":"ru.wikipedia.org","isTranslated":false,"description":"","greenUrl":"ru.wikipedia.org"},{"sourceId":2,"url":"https://semeynaya.ru/directions/khirurgiya/fistula-arteriovenoznaya/","shownUrl":"https://semeynaya.ru/directions/khirurgiya/fistula-arteriovenoznaya/","title":"Фистула артериовенозная","shortUrl":"semeynaya.ru","isTranslated":false,"description":"","greenUrl":"semeynaya.ru"},{"sourceId":3,"url":"https://medcentr-Sochi.ru/flebolog/arteriovenoznaya-fistula.html","shownUrl":"https://medcentr-Sochi.ru/flebolog/arteriovenoznaya-fistula.html","title":"Артериовенозная фистула: причины возникновения, симптомы и лечение у врача-флеболога в МКЦ «Проксима» (г. 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