Successful Treatment of Acquired Arteriovenous Fistulas after Iliac Vein Thrombosis

Gao, Xixiang; Guo, Jianming; Tong, Zhu; Guo, Lianrui; Zhang, Jian; Gu, Yongquan

doi:10.1016/j.avsg.2019.06.044

Cited by 5 publications

(8 citation statements)

References 13 publications

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“…Because natural history remains to be a puzzle, the management presents a conundrum. Though most of the papers in the review addressed the AVM by embolising or excluding it, the recent report by Gao et al effectively questions this line of treatment 10. Their patient underwent multiple episodes of embolisation followed by exclusion stenting of the AVF only to get symptomatic relief much later by successful venous stenting.…”

Section: Discussionmentioning

confidence: 99%

De novo arteriovenous malformations in post-thrombotic limbs

Kota

Kota²,

Agarwal³

et al. 2022

BMJ Case Rep

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A 50-year-old woman presented with progressive, painful and disabling swelling of the left lower limb following a left ovarian cyst excision 2 years ago. She had gross oedema of the left lower limb with multiple pubic varices. Contrast-enhanced CT and digital subtraction imaging revealed diffuse arteriovenous malformation (AVM) with feeders from the left internal iliac artery and a short segment significant stenosis of the proximal left common iliac vein. She underwent angioplasty and stenting of the left iliac vein. Her symptoms dramatically improved following the procedure and her limb swelling regressed within 6 months. The occurrence of post-thrombotic AVMs has been long established in the dural and portal systems. This report deals with an analogous phenomenon following iatrogenic deep venous thrombosis of the left lower limb, its pathogenesis, natural history and a review of treatment options.

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Section: Discussionmentioning

confidence: 99%

De novo arteriovenous malformations in post-thrombotic limbs

Kota

Kota²,

Agarwal³

et al. 2022

BMJ Case Rep

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“…Link et al 3 embolized a fistula without iliac vein recanalization, which was insufficient for skin ulceration and subsequently prompted venous sclerotherapy. Gao et al 4 reported a case of acquired AVFs following left common iliac artery thrombosis, and the patient received a unique series of recanalization treatments which led to an excellent clinical outcome. Yuan et al 5 achieved successful results by treating the patient with recanalization; the clinical outcome also indicated that venous occlusion or hypertension rather than AVF was the main problem of this pathologic process.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, previous research indicates that some AVFs may be associated with previous venous thrombosis. [3][4][5] The etiology of these lesions remains unknown. We present a case of acquired lower left extremity AVFs after left common iliac vein thrombosis, resulting in prolonged lower left extremity edema, that was successfully recanalized by stent implantation.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of acquired arteriovenous fistula following iliac vein thrombosis

Yang

2021

Vascular

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Objectives Cases of arteriovenous fistula following iliac vein thrombosis are uncommon. The pathogenesis of its formation remains unclear. We present the efficacy of left common iliac vein recanalization in acquired arteriovenous fistula treatment. Methods A 71-year-old man presented with severe lower left limb edema and was diagnosed with acquired arteriovenous fistula following iliac vein thrombosis. Treatment by recanalizing the left common iliac vein with bare stents was selected over embolizing the arteriovenous fistula, leading to an excellent clinical outcome. Results and Conclusions: Acquired arteriovenous fistula should be considered in some patients with post-thrombotic syndrome. Endovascular recanalization without embolization of the arteriovenous fistula can effectively treat iliac vein thrombosis associated with arteriovenous fistula.

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“…The disease was diagnosed by ultrasound (US) ( Figures 1A,B ) or CT angiography (CTA) ( Figures 1C,D ) and finally confirmed by digital subtraction angiography (DSA) ( Figures 1E,F ). The etiology for IAVFs was determined based on medical history, wherein acquired IAVFs were defined as fistulas formation secondary to trauma (traumatic IAVFs) or previous operation (iatrogenic IAVFs); Congenital IAVFs were defined as spontaneous formation of IAVFs without any history of trauma, surgery, or deep vein thrombosis (DVT) ( 8 – 11 ).…”

Section: Methodsmentioning

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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Successful Treatment of Acquired Arteriovenous Fistulas after Iliac Vein Thrombosis

Cited by 5 publications

References 13 publications

De novo arteriovenous malformations in post-thrombotic limbs

De novo arteriovenous malformations in post-thrombotic limbs

Successful treatment of acquired arteriovenous fistula following iliac vein thrombosis

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

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