Endovascular repair of post-traumatic, concomitant popliteal artery pseudoaneurysm and arteriovenous fistula

Franz, Randall W.; Jump, Mark A

doi:10.1055/s-0031-1278322

Cited by 17 publications

(12 citation statements)

References 17 publications

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“…Hence, we recommend liberal use of angiography following duplex scan rather than CTA, if the latter is not needed for other bodily injuries. This is in line as well with one of the largest series reporting on 27 operated cases of TAVF, the majority (except the ones who were unstable) had eventually angiography as a localizing modality [21].…”

Section: Discussionsupporting

confidence: 87%

“…Prior to angioplasty, PTA just beyond the fistula had severe stenosis, which caused our stent to be undersized, a common etiology for stent restenosis [28]. Moreover, a large number of indications in the reported surgical series were actually unsuccessful attempts at or failure of an endovascular treatment [21], speaking only of the challenging nature of those procedures and the high level of expertise to achieve technical success. Our proposed algorithm for management of pellets/shrapnels induced TAVF is summarized in Fig.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Background: Traumatic arteriovenous fistula (TAVF) is an uncommon vascular entity that arises in various locations, often from penetrating injuries, with a wide spectrum of signs and symptoms. This case report highlights the importance of suspecting multiple TAVFs after a single gunshot wound, especially if it involves pellets. It also sheds light on adapting treatment, whether endovascular or open repair, to the location and characteristics of each fistula. Case presentation: A 35-year-old male, with history of shotgun wound 5 months earlier, presented to our clinic with right lower extremity (RLE) edema and pain. Arterial duplex scan and subsequent angiogram showed two TAVFs at the popliteal and posterior tibial (PT) arteries, both of which could not be exactly localized with a computed tomography angiography (CTA) due to artifacts. The fistula connecting the posterior tibial artery (PTA) and vein was repaired endovascularly using a covered-stent, while the fistula between the popliteal artery and vein was repaired surgically. Postoperative follow-up at 3 months showed no arteriovenous fistula (AVF), patent vessels and distal stent stenosis at the PTA. Conclusions: Patients who sustain gunshot injuries with shrapnel or pellets and develop TAVF consequentially need to be followed up with the possibility of multiple AVFs in mind. Arterial duplex scan is highly sensitive to detect those AVFs, yet angiography remains gold standard, particularly with extensive metal artefacts. Endovascular repair, when feasible, should be considered first, unless the patient is unstable or has anatomical constraints that increase the risk of complications. Lastly, surgeons should be weary of deep venous thrombosis (DVT), the Branham effect and arterial aneurysmal dilation postoperatively.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…108,111 Mechanical thrombolysis may be required prior to angioplasty in order to resolve any clot associated with the dissection. 108 Covered stents, including the Viabahn (W. L. Gore & Associates, Inc), 111,112 Fluency (Bard), 92,107,113 Jostent (Abbott), 111 iCast (Atrium), 114 WALLGRAFT (Boston Scientific, Inc), 115 and Passager (Boston Scientific) 116 have been described to treat occlusions, transections, pseudoaneurysms, extravasation, and AC fistulas. Bare metal stents, including the Xceed (Abbott) 69 and Lifestent (Bard) 109 have been used to treat transections and pseudoaneurysms.…”

Section: Lower Extremitymentioning

confidence: 99%

Endovascular Therapy of Vascular Trauma—Current Options and Review of the Literature

Glaser

Kalapatapu

2019

Vasc Endovascular Surg

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Objective: To review the current use of endovascular techniques in trauma. Summary Background Data: Multiple studies have demonstrated that, despite current guidelines, endovascular therapies are used in instances of arterial trauma. Methods: The existing literature concerning arterial trauma was reviewed. Studies reviewed included case reports, single-center case series, large database studies, official industry publications and instructions for use, and society guidelines. Results: Endovascular therapies are used in arterial trauma in all systems. The use of thoracic endografts in blunt thoracic aortic trauma is accepted and endorsed by society guidelines. The use of endovascular therapies in other anatomic locations is largely limited to single-center studies. Advantages potentially include less morbidity due to smaller incisions as well as shorter operating room times. Many report using endovascular therapies even with hard signs of injury. Long-term results are limited by a lack of long-term follow-up but, in general, suggest that these techniques produce acceptable outcomes. The adoption of these techniques may be limited by resource and surgeon availability. Conclusions: The use of endovascular therapies in trauma has gained acceptance despite not yet having a place in official guidelines.

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“…We were able to perform a coil embolization rather safely given the risk of proximal coil migration was non existent since ATA was already clipped during open ligation of the fistula. There is no clear consensus as to which approach should be attempted first [ 6 ]. In summary, it is our preference patient undergoes open fistula ligation due to high complication rate of endovascular embolization and unexpected coil migration.…”

Section: Discussionmentioning

confidence: 99%

Retrograde embolization of anterior tibial artery for an iatrogenic arterio-venous fistula causing left lower extremity claudication

Qaja

Segal

Engler

et al. 2018

Journal of Surgical Case Reports

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Lower extremity angiogram is generally a safe and effective procedure with a low rate of vascular complications. We report here a unique case of a 33-year-old female with anterior tibial artery (ATA) to anterior tibial vein fistula formation after lower extremity endovascular intervention. This was initially treated with open repair of the fistula and ligation of ATA. However, patient continued to complain of claudication like symptoms. Patient subsequently had an endovascular embolization of ATA in a retrograde fashion. Recovery was unremarkable; patient was discharged home same day. Three months postoperatively patient denies leg pain, a follow-up arterial duplex failed to show presence of arterio-venous fistula. This case illustrates the effectiveness of an endovascular approach as a minimally invasive treatment for this uncommon complication that occurs after lower extremity endovascular intervention.

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Endovascular repair of post-traumatic, concomitant popliteal artery pseudoaneurysm and arteriovenous fistula

Cited by 17 publications

References 17 publications

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

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

Endovascular Therapy of Vascular Trauma—Current Options and Review of the Literature

Retrograde embolization of anterior tibial artery for an iatrogenic arterio-venous fistula causing left lower extremity claudication

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