Emergent stent graft isolation of a knife-related subclavian arterial venous fistula: lessons learned during long-term follow-up.
We present the unusual case of a 42-year-old gentleman who entered the trauma center with a hemothorax and intermittent bright red pulsatile blood from three stab wounds in the ipsilateral supraclavicular fossa. The patient was found on emergent angiography to have a large right subclavian artery to vein fistula that was treated successfully with a Dacron-covered stent. Angiography, 2 years following stent-graft isolation, confirmed a durable result with evidence of hemodynamically insignificant neointimal growth through the pores of the graft material. This case provides insight into the long-term effects of a Dacron-covered stent in patients with traumatic arterial injury. We discussed the advantages and disadvantages of different graft materials based on these angiographic findings.
Bates
Mark C
MC
CAMC, Health Education and Research Institute, Charleston, West Virginia, USA. mark.bates@camc.org
Campbell
John
J
D000328:Adult; D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D004630:Emergencies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D013898:Thoracic Injuries / Q000150:complications* / Q000601:surgery; D013997:Time Factors; D014951:Wounds, Stab / Q000150:complications* / Q000601:surgery