Ilio-Iliac Arteriovenous Fistulae—An Unusual Diagnosis with an Even More Unusual Clinical Presentation

Coelho, Andreia; Brandão, Pedro; Lobo, Miguel; Lojo, Ignatio; Canedo, Alexandra

doi:10.1016/j.avsg.2018.01.080

Cited by 11 publications

(11 citation statements)

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“…In contrast, in the 10 iatrogenic patients with IAVFs, uterine surgeries, including cesarean and hysterectomy, were thought to be the causes of 70% iatrogenic IAVFs, which also explained the high ratio of female patients. Several studies have found female patients presenting with IAVFs, uterine or pelvic AVFs after hysterectomy, suggesting the quite possible relationship between hysterectomy and IAVFs ( 18 – 20 ). However, there is still no direct evidence that uterine surgeries could lead to IAVFs.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Endovascular Management of Iliac Arteriovenous Fistulas: A 10-Year Single Center Experience

Liu

et al. 2022

Front. Surg.

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ObjectiveIliac arteriovenous fistulas (IAVFs) are rare abnormalities with limited reported cases. This study aimed to summarize the clinical features and experiences on the diagnosis and endovascular treatment of IAVFs.MethodsA single-center retrospective study of IAVFs from 2010 to 2019 was performed. Data including demographics, clinical characteristics, radiological images, surgical details, and follow-up were collected.ResultsA total of 16 patients diagnosed with IAVFs were identified. The female to male ratio was 3:1. The mean age was 47.7 ± 10.4 years (range: 35–73 years). Leg swelling and cardiac insufficiency, especially heart failure, were the most common primary symptoms in this series, which were revealed in 68.8 and 37.5% of patients, respectively. Iatrogenic, traumatic, and congenital IAVFs were diagnosed in 62.5, 12.5, and 25.0% of patients, respectively, among which hysterectomy was thought to be the main cause for female iatrogenic IAVFs (31.3%). Anatomic analysis found that internal iliac vessels were the predilected sites of IAVFs. All the patients were treated by endovascular procedures composed of transarterial embolization (50.0%), transarterial and stage II transvenous embolization (31.3%), stage I transarterial and transvenous embolization (12.5%), and transarterial embolization plus stent implantation (6.3%). The clinical success rate was 93.8%. Minor complications including fever (18.8%) and exudation at the puncture point (6.25%) were noted and well-treated. During a follow-up period of 51.3 ± 41.9 months after operations, only one patient experienced re-emergence of heart failure because of recurrence of leiomyosarcoma; other patients recovered uneventfully with symptoms relief and no severe embolization-related complications was encountered.ConclusionIAVFs are rare disorders and correct diagnosis requires careful history taking and physical examination, combined with proper imaging investigation. The primary goal for treatment of IAVFs was to relieve associated symptoms. Based on the results of this study, endovascular approach is safe and effective for treatment of IAVFs.

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Section: Discussionmentioning

confidence: 99%

Clinical Features and Endovascular Management of Iliac Arteriovenous Fistulas: A 10-Year Single Center Experience

Liu

et al. 2022

Front. Surg.

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“…We found two case reports of patients with no preceding orthopedic surgery presenting with progressive leg swelling and were found to have AVF after clinical suspicion of DVT. One patient developed acute kidney injury due to venous infarction, and the other developed neurological deficits [ 4 , 5 ]. We found several similar case reports with a history of orthopedic surgery.…”

Section: Discussionmentioning

confidence: 99%

Lower Extremity Arteriovenous Fistula Mimicking Deep Venous Thrombosis: A Case Report

Alwohaibi¹,

Alattab²,

AlSheef³

2021

Cureus

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Deep venous thrombosis (DVT) is the most common cause of unilateral lower limb swelling. Common differential diagnosis includes superficial thrombophlebitis and ruptured Baker's cyst. DVT is one of the most common complications diagnosed following lower extremity orthopedic surgery. However, many less frequent causes are often easily overlooked. Here we present a case of a 65-year-old man with a previous hip replacement who developed left-sided progressive leg swelling for years, which was managed initially with anticoagulation for provoked DVT and with compression stockings for post-thrombotic syndrome with no improvement. There was arterialization and spectral broadening of the venous waveform in the Doppler study. Computed tomography angiogram of the lower limbs showed evidence of arteriovenous fistula (AVF) with opacification of the deep left leg veins. Angioplasty and embolization of the fistula resulted in the resolution of leg swelling. We also discussed similar cases found in the literature. AVF needs to be considered in patients presenting with unilateral leg swelling following lower extremity orthopedic surgery.

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“…5 Treatment of these patients suffering from DVT in combination with AVF includes compression, surgical fistula ligation, embolization, sclerotherapy, and recanalization with bare stent as summarized in Table. Link et al 5,6 treated only the fistula by embolization with no consideration of recanalization with stent of the iliac vein, which was not sufficient for ulcer healing, thus prompting subsequent sclerotherapy. Coelho et al 9 performed embolization and stent-graft deployment in the internal iliac artery in an attempt to seal the arterial component of the AVF, with marginal success. Improvement in lower extremity edema and pain was achieved only after the CIV recanalization with bare stents.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Acquired Arteriovenous Fistulas after Iliac Vein Thrombosis

Gao

Guo

Tong

et al. 2020

Annals of Vascular Surgery

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Ilio-Iliac Arteriovenous Fistulae—An Unusual Diagnosis with an Even More Unusual Clinical Presentation

Cited by 11 publications

References 11 publications

Clinical Features and Endovascular Management of Iliac Arteriovenous Fistulas: A 10-Year Single Center Experience

Clinical Features and Endovascular Management of Iliac Arteriovenous Fistulas: A 10-Year Single Center Experience

Lower Extremity Arteriovenous Fistula Mimicking Deep Venous Thrombosis: A Case Report

Successful Treatment of Acquired Arteriovenous Fistulas after Iliac Vein Thrombosis

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