Endovascular repair of an iliac arteriovenous fistula secondary to perforation from a common iliac aneurysm in a patient with Ehler-Danlos syndrome.
BACKGROUND
Type IV Ehler-Danlos syndrome (EDS) patients are prone to life-threatening vascular complications. Surgical management of those complications is challenging owing to vessel wall fragility, which may result in hemorrhagic events and high mortality rates. Here we report a case of left common iliac aneurysm perforation of the ipsilateral iliac vein repaired using endovascular technique in a patient with EDS.


RESULTS
A 54-year-old patient presented with heart failure symptoms that evolved over 1 week in association with left leg edema and steal syndrome due to a perforation of the left iliac vein caused by a left common iliac aneurysm. A thrombosed right common iliac aneurysm and several other visceral and peripheral aneurysms were discovered on computed tomographic scan at admission. An aortouniiliac stent graft was used to seal the fistula. After 18 months of follow-up, the patient remained asymptomatic.


CONCLUSIONS
We suggest that endovascular therapy is useful to manage vascular complications in patients with EDS.
Department of Angiology, Vascular and Endovascular Surgery, Hospital Universitario Doctor Peset, Valencia, Spain. sala_and@gva.es
Vicente Andrés
VA
Sala Almonacil
José Miguel
JM
Zaragozá García
Francisco Julián
FJ
Gómez Palonés
Ángel
Á
Plaza Martínez
Eduardo
E
Ortíz Monzón
D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D057510:Endovascular Procedures; D006439:Hemodynamics; D006801:Humans; D017543:Iliac Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D007083:Iliac Artery / Q000503:physiopathology / Q000601:surgery*; D007084:Iliac Vein / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color