Our vascular surgical experience in arteriovenous fistula induced by gunshot injury

Abstract

Background: In this study, we aim to present our surgical experience in seven patients who were operated for arteriovenous fistula (AVF) induced by gunshot injury. Methods: Seven patients, who developed AVF as a result of gunshot injury and were operated at our clinic between November 2011 and August 2012, were included in this study. The patients were retrospectively evaluated in terms of injured body area, the timing of surgery, and surgical procedures performed. Results: Arteriovenous fistula was in the lower extremity in six patients (85.71%), and in the upper extremity in one patient (14.29%). In lower extremity, AVF was present between popliteal artery and popliteal vein in four patients, and between femoral artery and femoral vein in two patients. In upper extremity, AVF was located between brachial artery and cephalic vein. We performed primary repair of the artery and vein in four patients, graft interposition to artery and primary repair of vein in two patients, and graft interposition to artery and vein in one patient. Dacron graft was used for all patients. Conclusion: In penetrating injuries near major vascular structures, anamnesis and physical examinations should be conducted carefully, and auscultation should not be neglected. Indications for surgical treatment are present in all AVF patients. The requirement and timing of surgical treatment depend on the location and dimension, and the local and systemic effects of AVF. In large and post-traumatic AVFs, surgical treatment should be performed as early as possible.