Endovascular repair of a 63‐year‐old complication: post‐traumatic anterior tibial artery arteriovenous fistula

Endovascular Treatment of a Persistent Traumatic Deep Femoral Arteriovenous Fistula After Gunshot Injury

“…Open intervention for traumatic AVFs is associated with excessive blood loss and wound healing difficulties, so repair of these fistulas has been primarily via endovascular approaches. 9,10 In our case, an open exposure of the deep femoral artery and vein would have required dissection through a gunshot-exposed groin in the setting of aggressive venous collateralization and hypertension leading to unnecessarily excessive perioperative morbidity. It was a difficult decision to sacrifice the profunda femoral artery as it is a critical artery in maintaining limb viability in the setting of critical limb ischemia.…”

“…Open intervention for traumatic AVFs is associated with excessive blood loss and wound healing difficulties, so repair of these fistulas has been primarily via endovascular approaches. 9,10 In our case, an open exposure of the deep femoral artery and vein would have required dissection through a gunshot-exposed groin Figure 3. Embolization (A) of a distal branch of the PFA (white arrow) supplying the AVF did not fully resolve the pathology (not shown); therefore, the decision was made to embolize the proximal PFA as well.…”