Neurotechnology Neurotechnology Нейротехнология 6a84bda194fbba14f787620a Сосудистая нейрохирургия Vascular neurosurgery Сосудистая нейрохирургия Traumatic arteriovenous fistulas and posttraumatic pseudoaneurysms with neurological complications: diagnosis and modern managements ТРАВМАТИЧЕСКИЕ АРТЕРИОВЕНОЗНЫЕ ФИСТУЛЫ И ПОСТТРАВМАТИЧЕСКИЕ ПСЕВДОАНЕВРИЗМЫ С НЕВРОЛОГИЧЕС-КИМИ ОСЛОЖНЕНИЯМИ: ДИАГНОСТИКА И СОВРЕМЕННАЯ ТАКТИКА ЛЕЧЕНИЯ Симонян Армен Самвелович Simonyan Armen Samvelovich armenmed@mail.ru Акинфиев Василий Михайлович Akinfiev Vasiliy Mihaylovich Рагимова Айнур Алигейдаровна Ragimova Aynur Aligeydarovna Суслин Александр Станиславович Suslin Aleksandr Stanislavovich Гуща Артем Олегович Guscha Artem Olegovich Врач-нейрохирург нейрохирургическое отделение ФГБНУ НЦН Россия Врач-нейрохирург нейрохирургическое отделение ФГБНУ НЦН Russian Federation ФГБНУ «Российский центр неврологии и нейронаук» Россия ФГБНУ «Российский центр неврологии и нейронаук» Russian Federation ФГБНУ «Российский центр неврологии и нейронаук» Россия ФГБНУ «Российский центр неврологии и нейронаук» Russian Federation Военный учебно-научный центр военно-воздушных сил «Военно-воздушная академия имени профессора Н. Е. Жуковского и Ю. А. Гагарина» Россия Military Educational and Scientific Centre of the Air Force «Professor N.E. Zhukovsky and Y.A. Gagarin Air Force Academy» Russian Federation 04 08 2026 04 08 2026 6 04 08 2026 04 08 2026 © 2026 Симонян А.С., Акинфиев В.М., Рагимова А.А., Суслин А.С., Гуща А.О. © 2026 Simonyan A.S., Akinfiev V.M., Ragimova A.A., Suslin A.S., Guscha A.O. 2026 Симонян Армен Самвелович, Акинфиев Василий Михайлович, Рагимова Айнур Алигейдаровна, Суслин Александр Станиславович, Гуща Артем Олегович Simonyan Armen Samvelovich, Akinfiev Vasiliy Mihaylovich, Ragimova Aynur Aligeydarovna, Suslin Aleksandr Stanislavovich, Guscha Artem Olegovich https://journalneurotechnology.com/en/nauka/publications/6a84bda194fbba14f787620a/view

Введение. Травматические артериовенозные фистулы (ТАВФ) и посттравматические псевдоаневризмы (ПА) — редкие, но потенциально инвалидизирующие состояния: неврологические осложнения развиваются в 15–30% наблюдений. Пульсирующая ПА является одним из основных источников компрессии прилежащих нервных стволов. Разграничение прямого повреждения нерва и его компрессии определяет выбор метода лечения и прогноз, однако в литературе проводится редко. Цель. Систематизировать данные о диагностике и лечении ТАВФ и ПА с неврологическими осложнениями с учётом механизма поражения нерва и предложить практический алгоритм ведения пациентов. Методы. Анализ литературы в PubMed, Scopus, eLIBRARY (1990–2024) по ключевым словам: traumatic arteriovenous fistula, posttraumatic pseudoaneurysm, nerve injury, nerve compression, endovascular treatment, neurological deficit. Включены оригинальные статьи, систематические обзоры и клинические наблюдения. Использованы данные представленных тезисов. Результаты. Включено 30 источников. Наиболее часто при ТАВФ и ПА поражаются нервы нижних конечностей и плечевое сплетение. УЗИ с ЦДК является методом скрининга (чувствительность 85–97%). Нейросонография (7–18 МГц) непосредственно визуализирует нервный ствол: при компрессии — локальное утолщение, снижение эхогенности и увеличение площади поперечного сечения; при разрыве — прерывистость ствола и неврома. МРТ обязательна при глубокой локализации. Эндоваскулярная окклюзия даёт технический успех >90% при компрессии нерва. Восстановление функции при компрессии — 70–90%; при разрыве — 30–50%. Заключение. Предложен алгоритм диагностики и лечения ТАВФ и ПА с неврологическими осложнениями. МРТ рекомендуется как обязательный этап при подозрении на компрессию

**Introduction.** Traumatic arteriovenous fistulas (TAVFs) and post-traumatic pseudoaneurysms (PAs) are rare but potentially disabling conditions, with neurological complications occurring in 15–30% of cases. A pulsatile PA is one of the main causes of compression of adjacent nerve trunks. Differentiating between direct nerve injury and nerve compression is essential for treatment selection and prognosis; however, this distinction is rarely addressed in the literature. **Objective.** To systematize the available evidence on the diagnosis and treatment of TAVFs and PAs associated with neurological complications, taking into account the mechanism of nerve involvement, and to propose a practical patient management algorithm. **Methods.** A literature search was conducted in PubMed, Scopus, and eLIBRARY for publications from 1990 to 2024 using the following keywords: *traumatic arteriovenous fistula, post-traumatic pseudoaneurysm, nerve injury, nerve compression, endovascular treatment,* and *neurological deficit*. Original articles, systematic reviews, and case reports were included. Data from the presented conference abstracts were also used. **Results.** A total of 30 sources were included. In patients with TAVFs and PAs, the nerves of the lower extremities and the brachial plexus are most commonly affected. Duplex ultrasonography with color Doppler imaging is the preferred screening modality, with a sensitivity of 85–97%. High-resolution nerve ultrasonography using 7–18 MHz transducers enables direct visualization of the nerve trunk. Compression is characterized by focal nerve enlargement, reduced echogenicity, and an increased cross-sectional area, whereas nerve rupture is associated with discontinuity of the nerve trunk and neuroma formation. Magnetic resonance imaging is mandatory for deeply located lesions. Endovascular occlusion provides a technical success rate of more than 90% in cases of nerve compression. Functional recovery is achieved in 70–90% of patients with nerve compression and in 30–50% of those with nerve rupture. **Conclusion.** An algorithm for the diagnosis and treatment of TAVFs and PAs associated with neurological complications is proposed. Magnetic resonance imaging is recommended as a mandatory diagnostic step when nerve compression is suspected.

 травматическая артериовенозная фистула; посттравматическая псевдоаневризма; повреждение нерва; компрессия нерва; эндоваскулярное лечение; невролиз; диагностический алгоритм Traumatic arteriovenous fistula; post-traumatic pseudoaneurysm; nerve injury; nerve compression; endovascular treatment; neurolysis; diagnostic algorithm Отсутствует

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