title: Endovascular repair of a traumatic arteriovenous fistula 34 years after the injury: report of a case.
abstract: Penetrating extremity injuries can result in the development of arteriovenous fistulas (AVFs), whereby normal blood flow through the capillary bed is bypassed. Late complications of untreated AVFs include proximal arterial dilatation, venous congestion, congestive heart failure, and distal ischemia. We report the case of a 57-year-old man who was referred to us for treatment of a traumatic AVF with multiple sequelae, 34 years after he sustained a shrapnel injury to his right lower leg. We performed successful endovascular repair of this AVF with the patient under spinal anesthesia. Computed tomographic angiography (CTA) done 1 month and 6 months later confirmed AVF exclusion. Patients may present with sequelae of traumatic AVFs many years after their initial injury. Endovascular repair of AVFs offers several advantages over conventional repair and can be performed successfully even in the presence of complex anatomic abnormalities.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Mount Sinai School of Medicine, 5 East 98th Street, Box 1259, New York, NY 10029-6574, USA.
authors.forename: Donald T
authors.initials: DT
authors.lastname: Baril
authors.forename: Paula I
authors.initials: PI
authors.lastname: Denoya
authors.forename: Sharif H
authors.initials: SH
authors.lastname: Ellozy
authors.forename: Alfio
authors.initials: A
authors.lastname: Carroccio
authors.forename: Michael L
authors.initials: ML
authors.lastname: Marin
mesh_terms: D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000379:methods*; D014950:Wounds, Penetrating / Q000150:complications*