A Case of Superficial Femoral Arteriovenous Fistula and Severe Venous Stasis Ulceration, Managed with an Iliac Extender Prosthesis

Abstract

Most femoral artery arteriovenous fistulas occur as a result of percutaneous interventions. However, arteriovenous fistulas can occur in the setting of trauma, with resultant consequences such as heart failure, steal syndrome, or venous insufficiency. Indications for endovascular repair in this setting are limited to patients who are at too high risk for anesthesia, have a hostile groin, or would not survive significant bleeding. We report the case of a traumatic femoral arteriovenous fistula, causing severe venous insufficiency and arteriomegaly, in a 58-year-old male, with history of traumatic gunshot wound complicated by popliteal DVT. Surgical options for arteriovenous fistula include open and endovascular repair but this patient's fistula was more suitable for endovascular repair for reasons that will be discussed.

Management of dual traumatic arterial-venous fistula from a single shotgun injury: a case report and literature review

“…There are no clear guidelines as to what the next diagnostic step is. Although angiography remains the gold standard, it is common among practitioners to do a CTA as a second step (Table 1 ) [ 16 , 25 ]. In a systematic review and meta-analysis by Jens et al, CTA was shown to have a sensitivity and specificity of 96.2 and 99.2% respectively [ 26 ].…”