Acupuncture-induced popliteal arteriovenous fistula successfully treated with percutaneous endovascular intervention.
A 39-year-old female visited our cardiovascular outpatient department with paresthesia and soreness around the right popliteal fossa, where thrill was palpable. There was no history of trauma, apart from her having undergone acupuncture several years previously. An arteriovenous fistula (AVF) was diagnosed by vascular ultrasonography and magnetic resonance imaging. Angiography confirmed the presence of an AVF fed by the medial geniculate artery. Transarterial embolization was performed to close the AVF using coils and tissue adhesive. To the best of our knowledge, acupuncture-induced AVF has not been previously reported. We present a case demonstrating the merits of percutaneous endovascular intervention for treating this rare complication. The additional administration of a tissue adhesive can achieve complete closure of the AVF in the event of an unsatisfactory result following coil embolization. Doctors should be aware of the potential vascular complications of acupuncture, and of the management options.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Hsuan-Fu
HF
Kuo
Min-Chen Paul
MC
Shih
Wei-Pin
WP
Kao
Ho-Ming
HM
Su
Tsung-Hsien
TH
Lin
Wen-Chol
WC
Voon
Wen-Ter
WT
Lai
Sheng-Hsiung
SH
Sheu
D015670:Acupuncture Therapy / Q000009:adverse effects*; D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D011150:Popliteal Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014463:Ultrasonography