Transcatheter closure of a chronic iatrogenic arteriovenous fistula between the carotid artery and the brachiocephalic vein with an Amplatzer duct occluder in combination with a carotid stent.
We report an original method of transcatheter closure of an arteriovenous fistula using the combination of an Amplatzer PDA occluder and a carotid stent. The fistula was between the left carotid artery and the brachiocephalic vein. The patient had significant left-to-right shunt and was highly symptomatic. Due to the large orifice and pseudoaneurysmatic enlargement of the fistula, we had to use a large Amplatzer PDA occluder and the protruding part of the PDA device disk had to be covered with a carotid stent. The fistula was completely closed. The patient stopped having symptoms and, 2 years after the procedure, the effect persists.
1st Department of Medicine, Faculty of Medicine Hradec Kralove, Charles University Prague, Cardiocenter of University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic. stasek@fnhk.cz
Josef
J
Stasek
Miroslav
M
Lojik
Josef
J
Bis
David
D
Horak
Jaroslav
J
Dusek
Miroslav
M
Brtko
Pavel
P
Polansky
Anush
A
Babu
Jan
J
Vojacek
D000368:Aged; D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016121:Brachiocephalic Veins / Q000293:injuries*; D006328:Cardiac Catheterization / Q000379:methods*; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D015607:Stents; D014057:Tomography, X-Ray Computed