Novel Approach to a Giant External Iliac Vein Aneurysm Secondary to Posttraumatic Femoral Arteriovenous Fistula

Vasc Endovascular Surg. 2015 Jul-Aug;49(5-6):148-51. doi: 10.1177/1538574415602781. Epub 2015 Sep 2.

Abstract

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.

Keywords: anticoagulation; covered stent; endovascular; iliac venous aneurysms; traumatic arteriovenous fistula.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm / diagnosis
  • Aneurysm / etiology
  • Aneurysm / therapy*
  • Arteriovenous Fistula / diagnosis
  • Arteriovenous Fistula / etiology
  • Arteriovenous Fistula / therapy*
  • Endovascular Procedures* / instrumentation
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / injuries*
  • Femoral Vein / diagnostic imaging
  • Femoral Vein / injuries*
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Iliac Vein / diagnostic imaging
  • Iliac Vein / injuries*
  • Male
  • Middle Aged
  • Phlebography / methods
  • Stents
  • Thigh / blood supply*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vascular System Injuries / diagnosis
  • Vascular System Injuries / etiology
  • Vascular System Injuries / therapy*
  • Wounds, Gunshot / diagnosis
  • Wounds, Gunshot / etiology
  • Wounds, Gunshot / therapy*

Substances

  • Fibrinolytic Agents