Transvenous embolization of a spontaneous femoral AVF 5 years after an incomplete treatment with arterial stent-grafts.
A 66-year-old man with complex left femoral arterio-venous fistula (AVF) was first diagnosed after a deep venous thrombosis incident approximately 5 years ago. Partial treatment was performed by means of endografts along the superficial femoral artery, which remained patent for 5 years. The patient had been doing well until a couple of months ago when he developed severe venous stasis and ulcers of the left cruris, due to a high-flow nonhealing complex AVF with additional iliac vein occlusion. Therefore; the definitive treatment was performed by a unique endovascular technique combined with surgical venous bypass (femoro-femoral crossover saphenous bypass, the Palma operation). A novel percutaneous transvenous technique for occlusion of a complex high-flow AVF is reported with a review of the literature. The case is unique with spontaneous AVF, transvenous embolization with detachable coils and ONYX, and the hybrid treatment technique as well as the long-term patency of superficial femoral artery stent-grafts.
Peynircioglu
Bora
B
Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey. borapeynir@gmail.com
Ozkan
Murat
M
Dogan
Omer Faruk
OF
Cil
Barbaros E
BE
Dogan
Riza
R
D000368:Aged; D000792:Angiography; D001164:Arteriovenous Fistula / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D004621:Embolization, Therapeutic / Q000379:methods*; D005263:Femoral Artery; D006801:Humans; D007084:Iliac Vein; D008297:Male; D015607:Stents