I77.0
Arteriovenous fistula, acquired
Clinical Classification Guidelines
Inclusion Terms
- Aneurysmal varix
- Arteriovenous aneurysm, acquired
Excludes Type 1
- arteriovenous aneurysm NOS (Q27.3-)
- presence of arteriovenous shunt (fistula) for dialysis (Z99.2)
- traumatic - see injury of blood vessel by body region
Excludes Type 2
- cerebral (I67.1)
- coronary (I25.4)
Medical Intelligence & Overview
An acquired arteriovenous fistula (AVF) is an abnormal connection that develops between an artery and a vein, bypassing the capillary system. This condition is different from congenital fistulas, as it occurs due to an injury, medical procedure, or other factors that disrupt the normal vascular structure. The condition can affect blood flow and may lead to complications if not properly managed. Understanding the causes, symptoms, and treatment options is important for patients diagnosed with this condition.
Causes & Symptoms
Clinical Causes: Traumatic injury to blood vessels—such as from accidents or penetrating wounds Complications from vascular or cardiac surgeries involving blood vessels Infections that cause tissue damage and blood vessel destruction Inflammatory conditions affecting blood vessels (vasculitis) Radiation therapy near blood vessels, leading to vessel damage Development of aneurysmal varices or acquired arteriovenous aneurysms
Key Symptoms: Swelling or a palpable thrill or bruit (whooshing sound) over the affected area Localized pain or tenderness Changes in skin color or temperature over the fistula Symptoms of high-output heart failure in severe cases, including fatigue and shortness of breath Visible pulsatile mass in some instances Possible skin ulceration or necrosis in advanced cases
Diagnostic & Treatment
Diagnosis Path: Diagnosis typically involves physical examination, where healthcare providers listen for abnormal sounds (bruits) and feel for thrills. Imaging studies such as Doppler ultrasound, magnetic resonance angiography (MRA), or computed tomography angiography (CTA) are used to visualize the abnormal vessel connection and assess its size and impact. In some cases, invasive angiography may be performed for definitive diagnosis and planning treatment.
Treatment Protocols: Treatment options depend on the size, location, and impact of the fistula and may include: - **Observation:** Small, asymptomatic fistulas might be monitored regularly. - **Endovascular procedures:** Minimally invasive techniques such as catheter-based embolization or coil placement to close the abnormal connection. - **Surgical repair:** Removing or bypassing the fistula through open surgery if necessary. - **Management of complications:** Addressing heart failure symptoms or skin ulcers if they develop. The goal of treatment is to eliminate the abnormal connection, restore normal blood flow, and prevent complications.
Clinical Advice & FAQs
Billing Guidance
Is I77.0 a billable ICD-10 code?
Yes, I77.0 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report I77.0?
Clinical documentation must specify the nature of Arteriovenous fistula, acquired and any associated comorbidities for accurate reporting.
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