title: Hybrid management of a spontaneous ilio-iliac arteriovenous fistula: a case report.
abstract: BACKGROUND
  Spontaneous iliac arteriovenous fistulae are a rare clinical entity. Such localized fistulation is usually a result of penetrating traumatic or iatrogenic injury. Clinical presentation can vary greatly but commonly includes back pain, high-output congestive cardiac failure and the presence of an abdominal bruit. Diagnosis, therefore, is often incidental or delayed.
  
  
  METHODS
  We report a case of a spontaneous ilio-iliac arteriovenous fistula in a 68-year-old Caucasian man detected following presentation with unilateral claudication and congestive cardiac failure. Following computed tomography evaluation, the fistula was successfully treated with a combined endovascular (aorto-uni-iliac device) and open (femoro-femoral crossover) approach.
  
  
  CONCLUSIONS
  Endovascular surgery has revolutionized the management of such fistulae and we report an interesting case of a high-output iliac arteriovenous fistulae successfully treated with a hybrid vascular approach.
authors.affiliation: St James' Hospital Vascular Department, St James' Hospital, Dublin 6, Ireland. gavinobrien@rcsi.ie.
authors.forename: Gavin C
authors.initials: GC
authors.lastname: O'Brien
authors.forename: Colm
authors.initials: C
authors.lastname: Murphy
authors.forename: Zenia
authors.initials: Z
authors.lastname: Martin
authors.forename: Naseem
authors.initials: N
authors.lastname: Haider
authors.forename: Mary P
authors.initials: MP
authors.lastname: Colgan
authors.forename: Dermot
authors.initials: D
authors.lastname: Moore
authors.forename: Prakash
authors.initials: P
authors.lastname: Madhavan
authors.forename: Sean M
authors.initials: SM
authors.lastname: O'Neill