title: Treatment of an unusual complication of endovenous laser therapy: multiple small arteriovenous fistulas causing complete recanalization.
abstract: A 67-year-old woman was admitted to our institution with pain, night cramping, and visible varicose veins on her left leg. Doppler ultrasonography revealed continuous reflux in the great saphenous vein when the patient did the Valsalva maneuver. Endovenous laser therapy was applied to the great saphenous vein. Doppler ultrasonography 7 days later showed recanalization of, and arterialized flow in, the great saphenous vein. There also were small arterial vessels adjunct to the recanalized side. A left femoral angiography via a right femoral approach showed multiple small arteriovenous fistulas between superficial femoral artery muscle branches and the great saphenous vein. A second endovenous laser treatment was done at 80 J/cm, but the recanalization persisted. We offered to treat this endovascularly, but the patient preferred a surgical option. To the best of our knowledge, this is the first report of the demonstration of such a complication with endovenous laser therapy.
authors.affiliation: Department of Radiology, Baskent University Medical School, Selcuklu, Konya, Turkey. drerkany@yahoo.com
authors.forename: Erkan
authors.initials: E
authors.lastname: Yildirim
authors.forename: Tonguc
authors.initials: T
authors.lastname: Saba
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozulku
authors.forename: Ali
authors.initials: A
authors.lastname: Harman
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Aytekin
authors.forename: Fatih
authors.initials: F
authors.lastname: Boyvat
mesh_terms: D000368:Aged; D000792:Angiography; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D012501:Saphenous Vein; D018608:Ultrasonography, Doppler; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000628:therapy*