title: Transvenous embolization of a spontaneous femoral AVF 5 years after an incomplete treatment with arterial stent-grafts.
abstract: 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.
authors.affiliation: Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey. borapeynir@gmail.com
authors.forename: Bora
authors.initials: B
authors.lastname: Peynircioglu
authors.forename: Murat
authors.initials: M
authors.lastname: Ozkan
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Dogan
authors.forename: Barbaros E
authors.initials: BE
authors.lastname: Cil
authors.forename: Riza
authors.initials: R
authors.lastname: Dogan
mesh_terms: 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