Two cases of arteriovenous fistula formation between the external iliac vessels following endovenous laser therapy

Wheatcroft,; Lindsay, T.; Lossing, Alan G.

doi:10.1177/1708538114524394

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…Three of the cases reported were of an AVF within the EIV and the EIA after EVLT. Wheatcroft et al 7 state that external iliac fistulation due to EVLT is likely caused by inadvertent advancement of the probe through the SFJ into the EIV with activation of the laser while still within the EIV.…”

Section: Discussionmentioning

confidence: 99%

Arteriovenous Fistula Is a Rare but Significant Finding After Endovenous Thermal Ablation

Kelly

Sanford

Stoughton

2019

Journal for Vascular Ultrasound

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Endovenous thermal ablation (EVTA) has become the mainstay of treatment for symptomatic varicose veins in the setting of saphenous vein insufficiency. We observed 5 iatrogenic arteriovenous fistulas (AVFs) following thermal ablation of the great saphenous vein (GSV). Postprocedure duplex ultrasound (DUS) results were analyzed for the presence of AVF in any location along or adjacent to the treated saphenous veins. Cases were prospectively followed. English literature was reviewed for any other published reports of AVF after EVTA. Data were compiled using our 5 cases, 2 cases were shared with us by colleagues and 20 cases were reported in the literature. Our center has performed more than 4000 (4155) cases of EVTA over the past 15 years. Five cases of AVFs were detected, 3 were found in asymptomatic patients during routine post-EVTA surveillance. The additional 2 cases presented with signs or symptoms which prompted a DUS after ablation. Including cases in the literature, we were able to identify 2 different types of AVFs. The first type of AVF was demonstrated in 13 cases where the AVF occurred along the treated vein. All of these cases involved ablation of the GSV and 90% of these showed signs of recanalization. The second type of AVF was seen in 14 additional cases where the AVF involved a vein segment adjacent to or remote from the ablated vein. The second type occurred in the GSV in 5 cases, external iliac vein (EIV) in 3 cases, and in the popliteal vein in 5 cases. There is 1 reported case of AVF involving the sural artery after perforator vein EVTA. Three of the type 1 cases were followed and spontaneously resolved; 3 of the type 1 cases were treated with surgical ligation with unreported outcomes. Seven cases did not report any follow-up information. Seven of the type 2 cases were treated, and had spontaneous resolution and 7 were not treated. The follow-up on these cases ranged from 1 month to 6 years. Thermal ablation can result in AVF either along the length of the treated vein or adjacent to the area of ablation. Further study would help elucidate the cause and treatment algorithms.

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Section: Discussionmentioning

confidence: 99%

Arteriovenous Fistula Is a Rare but Significant Finding After Endovenous Thermal Ablation

Kelly

Sanford

Stoughton

2019

Journal for Vascular Ultrasound

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“…In allen Fällen mussten die Fremdkörper operativ entfernt werden [26]. In der Literatur findet man außerdem Beschreibungen über die postinterventionelle Ausbildung einer arteriovenösen Fistel und dem aneurysma spurium durch die versehentliche Punktion der Arterie während der Lokalanästhesie für die endoluminale Lasertherapie [27,28].…”

Section: Seltene Komplikationenunclassified

Varizenchirurgie: Belastender als andere Verfahren?

Brunig¹,

Buhr²

2019

Phlebologie

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ZusammenfassungSämtliche in der Varizenchirurgie angewandten Verfahren beherbergen Risiken. Die Risiken der klassischen operativen Sanierung der Varikosis mittels Stripping sind in der Literatur sehr ausführlich beschrieben.Bei den neueren therapeutischen Optionen, wie z. B. den endovenösen Therapien oder der Schaumsklerosierung werden die möglichen Komplikationen erst in jüngerer Zeit systematisch ausgewertet. Dementsprechend liegen derzeit im Vergleich wenige Daten hierzu vor.Betrachtet man die Lebensqualität des Patienten in den neuesten Vergleichsstudien und Metaanalysen, zeigt sich, dass perioperativ kaum Unterschiede in der Mobilität, Mortalität und Lebensqualität des Patienten bei den unterschiedlichen Therapieverfahren bestehen [1].Insgesamt ist davon auszugehen, dass die klassische operative Sanierung der Varikosis mittels Crossektomie, Stripping und Miniphlebektomien im Vergleich zu den endovenösen Therapieverfahren sowohl mit einem erhöhten Blutungsrisiko, also auch mit einem erhöhten postoperativen Infektionsrisiko einhergeht. Grundsätzlich ist das Blutungsrisiko, als auch das Infektionsrisiko jedoch auch bei der Operation als niedrig einzuschätzen.Das perioperative Nervenverletzungsrisiko scheint bei beiden Verfahren ähnlich häufig zu sein, wobei repräsentative Daten aus Vergleichsstudien fehlen.Das postoperative Thromboserisiko mit ggf. konsekutiver Lungenarterienembolie ist unseres Erachtens nach bei den endovenösen Verfahren höher einzustufen als nach einer klassischen operativen Sanierung der Varikosis.Kosmetisch beeinträchtigende, postinflammatorische Hyperpigmentierungen im OP-Gebiet treten häufiger nach endovenösen Therapieverfahren und nach Sklerosierungstherapien auf.

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“…AVF formation is a rare complication of EVLT for varicose veins (1,2). We believed that an external iliac artery stent graft not only would be at increased risk of migration, thrombosis, and fracture but also would likely require a surgical cutdown for deployment.…”

Section: Editormentioning

confidence: 99%

Use of an AMPLATZER Duct Occluder Device to Treat a Recurrent Arteriovenous Fistula following Endovenous Laser Treatment

Woodley-Cook

Noël-Lamy

Tan

et al. 2015

Journal of Vascular and Interventional Radiology

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Two cases of arteriovenous fistula formation between the external iliac vessels following endovenous laser therapy

Cited by 6 publications

References 14 publications

Arteriovenous Fistula Is a Rare but Significant Finding After Endovenous Thermal Ablation

Arteriovenous Fistula Is a Rare but Significant Finding After Endovenous Thermal Ablation

Varizenchirurgie: Belastender als andere Verfahren?

Use of an AMPLATZER Duct Occluder Device to Treat a Recurrent Arteriovenous Fistula following Endovenous Laser Treatment

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