Novel Approach to a Giant External Iliac Vein Aneurysm Secondary to Posttraumatic Femoral Arteriovenous Fistula.
We describe a case of a 55-year-old male with a remote history of a gunshot wound to the left thigh who presented with a 1-year history of worsening high-output congestive heart failure, left lower extremity edema, and left lower abdominal discomfort. Diagnostic evaluation included a computed tomographic angiography (CTA) that demonstrated a fistulous communication between the left superficial femoral artery (SFA) and vein (SFV) as well as a 7.2-cm external iliac vein aneurysm. Given his symptomatology, an endovascular repair of his AVF was recommended, followed by antithrombotic therapy for his aneurysm. Three-month postoperative CTA confirmed AVF exclusion as well as a significant decrease in maximal diameter of the left external iliac vein aneurysm now measuring 24 mm. This case is the first reported successful mid-term repair of a iliac venous aneurysm in the setting of a traumatic arteriovenous fistula using an endovascular approach.
Division of Vascular Surgery, Stanford University, Stanford, CA, USA thompspg@stanford.edu.
Patrick C
PC
Thompson
Division of Vascular Surgery, Stanford University, Stanford, CA, USA.
Brant W
BW
Ullery
Division of Vascular Surgery, Stanford University, Stanford, CA, USA.
Dominik
D
Fleischmann
Division of Vascular Surgery, Stanford University, Stanford, CA, USA.
Venita
V
Chandra
D000783:Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D057510:Endovascular Procedures / Q000295:instrumentation; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D015607:Stents; D013848:Thigh / Q000098:blood supply*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
D005343:Fibrinolytic Agents
anticoagulation; covered stent; endovascular; iliac venous aneurysms; traumatic arteriovenous fistula