Hybrid management of a spontaneous ilio-iliac arteriovenous fistula: a case report

Abstract

IntroductionSpontaneous iliac arteriovenous fistulae are a rare clinical entity. Such localized fistulation is usually a result of penetrating traumatic or iatrogenic injury. Clinical presentation can vary greatly but commonly includes back pain, high-output congestive cardiac failure and the presence of an abdominal bruit. Diagnosis, therefore, is often incidental or delayed.Case presentationWe report a case of a spontaneous ilio-iliac arteriovenous fistula in a 68-year-old Caucasian man detected following presentation with unilateral claudication and congestive cardiac failure. Following computed tomography evaluation, the fistula was successfully treated with a combined endovascular (aorto-uni-iliac device) and open (femoro-femoral crossover) approach.ConclusionEndovascular surgery has revolutionized the management of such fistulae and we report an interesting case of a high-output iliac arteriovenous fistulae successfully treated with a hybrid vascular approach.

Treatment of Iliac Arteriovenous Malformation Associated with Trisomy 21: A Case Report

“…Additionally, AVMs in different locations exhibit unique clinical presentations [3]. Typical symptoms of iliac AVM include back pain (70%) [4] and ipsilateral lower limb swelling due to increased ow through the venous pathway. This can cause venous dilation in the bladder wall, vagina, and rectal wall, leading to hematuria, excessive vaginal bleeding, and gastrointestinal bleeding, which is rare in pelvic AVMs.…”

Reparación endovascular de aneurisma de arteria iliaca común asociado a fistula arterio-venosa ilio-ilíaca: Reporte de caso

“…De igual manera desde la década de los noventa, se prefiere para el manejo de las FII las técnicas endovasculares, identificando un mayor perfil de seguridad en los pacientes llevados a este tipo de intervenciones 9 .…”

“…Como patología independiente las fístulas ílioilíacas (FII) son una entidad bastante infrecuente, asociada principalmente a lesiones penetrantes o a iatrogenia, en raras ocasiones se presentan como un cuadro clínico agudo; su reparación vía abierta presenta una tasa de mortalidad entre el 9% al 34% 9 .…”

Hybrid treatment of arteriovenous fistula between popliteal vessels

“…[1][2][3] Clinical presentation and the time interval between suffering the trauma and diagnosis of AVF can vary greatly; in some cases detection occurs decades after the injury. 3,4 A range of different surgical techniques are commonly used to treat traumatic AVFs in the extremities, including ligature, disconnections with direct repair and resection of the fistula with reconstruction of vessels. However, recent reports show that endovascular techniques are becoming ever more routine.…”