Arteriovenous fistula of the internal mammary artery (combat injury): transcatheter intravascular coil occlusion

Abstract

A case of arteriovenous fistula of the left internal mammary artery occluded by Gianturco coil is reported. A 26-year-old male suffered multiple explosive injuries. Right heart failure developed postoperatively. Digital subtraction angiography demonstrated arteriovenous fistulas between the left internal mammary artery and left subclavian and innominate veins. Considering previous multiple surgical interventions and severe general condition of the patient, both arteriovenous fistulas were successfully occluded by transcatheter placement of a Gianturco coil.

Traumatic Internal Mammary Injury— A Literature Review and Guide for Management

“…Transection (38.6%) was the most common injury pattern, followed by contrast extravasation (35.1%) and aneurysm/pseudoaneurysm (17.5%). Arteriovenous stulas (AVFs) with various adjacent veins were not common but were reported in 5 cases (8.8%) (3,6,19,20,30).…”

“…Before multidetector CT was prevalent, angiography was arranged for patients with a high suspicion of mediastinal vessel injury. In our review, eight patients underwent angiography without CT, all of whom were from studies before 2000 (3,6,15,17,19,30,34,37). After 2000, although diagnosis and treatment could be performed simultaneously by angiography, most physicians chose contrast-enhanced chest CT as the diagnostic tool because of its easy accessibility and ability to provide more comprehensive information.…”

“…Notably, not all IMA injuries were identi ed at the beginning. Nearly 10% (7 patients) had a delayed presentation (6,8,19,20,25,30,37), especially those with AVF (4 in 5 patients). The duration from the trauma to the delayed diagnosis ranged from 1 week to 10 months.…”

Congenital arteriovenous fistula of internal thoracic artery: Successfully managed by transcatheter embolization

“…The fistulae in the distal internal thoracic artery may connect to the vitelline venous system [2]. Recent reports reveal that traumatic events such as stab wounds, sternotomy, and central venous catheterization are the most frequent causes [3][4][5].…”

“…To date, only seven congenital arteriovenous fistulae of the internal thoracic artery have been reported, and of these only four were to the internal thoracic vein [1]. Recent reports include such etiologies as sternotomy [3], central venous catheterization [4], and trauma [5]. Serious life-threatening complications can occur, and consequently obliteration of the fistula may be required [4].…”