Staged Treatment of a Femoral Arteriovenous Fistula after Gunshot Injury

Abstract

Thirty-four years after incurring a gunshot wound in the right thigh, a 69 year old man presented with severe heart failure caused by a femoral arteriovenous fistula (AVF). Computed tomography angiography revealed a 15 × 30 mm fistula (A, arrow) between the dilated femoral artery and vein, which was unsuitable for complete endovascular repair. An 18 mm vascular plug (LifeTech Scientific, Shenzhen, China) was deployed in the external iliac artery (asterisk) to reduce lood flow and improve the patient’s general condition. Ten days later, the defect was repaired with a linear shaped suture (B, arrow). Recovery was uneventful.Image 1