The occurrence of arterio-venous fistula during lower limb subintimal angioplasty: treatment and outcome.
OBJECTIVE
To describe our experience with iatrogenic arterio-venous fistula (AVF) occurring during lower limb subintimal angioplasty, their management and the final clinical, radiological outcome.


METHODS
Retrospective review of case series from two centres, from a computerised database over a period of five years.


METHODS
Twelve patients whose lower limb subintimal angioplasty was complicated by Iatrogenic AVF.


RESULTS
The Majority of AVF occurred at the popliteal trifurcation vessels. And the incidence of this complication in our case series was 0.8%. This was managed with a variety of techniques-Coil embolisation, balloon tamponade, alternative dissection and stent placement. In one patient, the fistula was left open intentionally. All twelve patients had a successful angioplasty. The overall technical success rate for AVF ablation was eighty percent.


CONCLUSIONS
AVF is a potential complication of angioplasty. The majority can be managed by endovascular means during the angioplasty procedure with good technical success.
Ananthakrishnan
G
G
Department of Surgery, Derbyshire Royal Infirmary, Derby, DE1 2QY, UK. ananth_26@yahoo.co.in
DeNunzio
M
M
Bungay
P
P
Pollock
G
G
Fishwick
G
G
Bolia
A
A
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects* / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D021721:Balloon Occlusion; D002404:Catheterization; D004621:Embolization, Therapeutic; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D015994:Incidence; D007511:Ischemia / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D016347:Medical Records Systems, Computerized; D011150:Popliteal Artery / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D017539:Tunica Intima / Q000601:surgery; D014654:Vascular Patency; D014656:Vascular Surgical Procedures