title: Iatrogenic Arteriovenous Fistula With Associated Pseudoaneurysm of Posterior Tibial Artery After Revision Total Ankle Arthroplasty: A Case Report.
abstract: Iatrogenic vascular injuries in elective orthopedic surgery are rare. However, these are important complications to recognize early and treat appropriately because the potential sequelae can be devastating. Arteriovenous fistula of the lower extremity after total ankle arthroplasty has not been previously described in published studies. The proper diagnosis of arteriovenous fistulas can be difficult without a high index of suspicion, and treatment often involves surgical intervention. We present the case of a 62-year-old male who developed an iatrogenic arteriovenous fistula with associated pseudoaneurysm of the posterior tibial artery after revision total ankle arthroplasty that was treated with surgical ligation and excision, followed by reverse saphenous vein grafting.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Wooster
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC. Electronic address: nathan.grimm@duke.edu.
authors.forename: Nathan L
authors.initials: NL
authors.lastname: Grimm
authors.affiliation: Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC.
authors.forename: James K
authors.initials: JK
authors.lastname: DeOrio
authors.affiliation: Assistant Professor of Orthopaedic Surgery and Plastic Surgery, Division of Plastic Surgery, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Suhail K
authors.initials: SK
authors.lastname: Mithani
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D058737:Arthroplasty, Replacement, Ankle / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation / Q000009:adverse effects / Q000379:methods; D012501:Saphenous Vein / Q000637:transplantation*; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D016378:Tissue Transplantation / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014656:Vascular Surgical Procedures / Q000379:methods
keywords: arteriovenous fistula; iatrogenic injury; total ankle arthroplasty