Diagnosis and treatment of acquired arteriovenous fistula after lower extremity deep vein thrombosis

Hai, Yong; Sun, Jing; Zhou, Zhengtong; Qi, Hengtao; Wang, Maohua; Dong, Dianning; Wu, Xuejun

doi:10.23736/s0392-9590.19.04063-x

Cited by 12 publications

(17 citation statements)

References 17 publications

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“…Yuan et al reported 24 cases of AVF diagnosed after initial diagnosis of DVT not related to previous surgery or trauma. All cases had severe stenosis or occlusion of left CIV, similar to our patient, raising suspicion of a causal relation between DVT and AVF [ 8 ].…”

Section: Discussionsupporting

confidence: 71%

Lower Extremity Arteriovenous Fistula Mimicking Deep Venous Thrombosis: A Case Report

Alwohaibi¹,

Alattab²,

AlSheef³

2021

Cureus

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Deep venous thrombosis (DVT) is the most common cause of unilateral lower limb swelling. Common differential diagnosis includes superficial thrombophlebitis and ruptured Baker's cyst. DVT is one of the most common complications diagnosed following lower extremity orthopedic surgery. However, many less frequent causes are often easily overlooked. Here we present a case of a 65-year-old man with a previous hip replacement who developed left-sided progressive leg swelling for years, which was managed initially with anticoagulation for provoked DVT and with compression stockings for post-thrombotic syndrome with no improvement. There was arterialization and spectral broadening of the venous waveform in the Doppler study. Computed tomography angiogram of the lower limbs showed evidence of arteriovenous fistula (AVF) with opacification of the deep left leg veins. Angioplasty and embolization of the fistula resulted in the resolution of leg swelling. We also discussed similar cases found in the literature. AVF needs to be considered in patients presenting with unilateral leg swelling following lower extremity orthopedic surgery.

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Section: Discussionsupporting

confidence: 71%

Lower Extremity Arteriovenous Fistula Mimicking Deep Venous Thrombosis: A Case Report

Alwohaibi¹,

Alattab²,

AlSheef³

2021

Cureus

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“…In the present case of AVF in DVT, revascularization was successful for reducing venous collaterals and AVF and for improving symptoms. DVT is considered a rare cause of AVF [ 7 ]. The exact pathogenesis of such acquired AVF remains unclear, although venous hypertension is regarded as a primary source [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Successful endovascular treatment with a stent graft for chronic deep vein thrombosis with multiple arteriovenous fistulas: a case report

et al. 2022

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Background Deep vein thrombosis with arteriovenous fistulas is rare, with few therapeutic options available for chronic-phase deep vein thrombosis. Moreover, the effectiveness of endovascular treatment for chronic-phase deep vein thrombosis with arteriovenous fistulas has not been established. We describe herein a case of successful endovascular treatment for chronic deep vein thrombosis with multiple arteriovenous fistulas. Case presentation We describe the case of a 72-year-old Asian woman who had begun experiencing left leg swelling and intermittent claudication 2 years prior. Enhanced computed tomography revealed left common iliac vein occlusion with vein-to-vein collateral formation and several arteriovenous fistulas. Angiography and ultrasound showed the arteriovenous fistulas to run from the common and internal iliac arteries to the external iliac and superficial femoral veins. We opted against surgical repair for the arteriovenous fistulas due to their complex nature and complicated morphology. Since her condition was progressive, endovascular treatment with a stent graft was performed for the deep vein thrombosis, after which her symptoms gradually improved. Four months following the procedure, enhanced computed tomography confirmed remarkable reduction of the vein-to-vein collaterals and arteriovenous fistulas. Conclusions In the present case, enhanced computed tomography with a stent graft was effective in improving symptoms. This strategy may therefore be a treatment option for intractable chronic deep vein thrombosis with arteriovenous fistulas.

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“…Gao et al 4 reported a case of acquired AVFs following left common iliac artery thrombosis, and the patient received a unique series of recanalization treatments which led to an excellent clinical outcome. Yuan et al 5 achieved successful results by treating the patient with recanalization; the clinical outcome also indicated that venous occlusion or hypertension rather than AVF was the main problem of this pathologic process. Moreover, treatment focused on recanalization with or without embolization consistently exhibited better prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…A possible mechanism is that the venous components of the AVF shrunk, or even close, due to venous hypertension relief. 9 Meanwhile, as the venous pressure decreased, the distance between veins and arteries increased, leading to the narrowing or closing of AVFs, 5 with its treatment dependent on the arteriography after the venous recanalization.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, previous research indicates that some AVFs may be associated with previous venous thrombosis. [3][4][5] The etiology of these lesions remains unknown. We present a case of acquired lower left extremity AVFs after left common iliac vein thrombosis, resulting in prolonged lower left extremity edema, that was successfully recanalized by stent implantation.…”

Section: Introductionmentioning

confidence: 99%

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Successful treatment of acquired arteriovenous fistula following iliac vein thrombosis

Yang

2021

Vascular

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Objectives Cases of arteriovenous fistula following iliac vein thrombosis are uncommon. The pathogenesis of its formation remains unclear. We present the efficacy of left common iliac vein recanalization in acquired arteriovenous fistula treatment. Methods A 71-year-old man presented with severe lower left limb edema and was diagnosed with acquired arteriovenous fistula following iliac vein thrombosis. Treatment by recanalizing the left common iliac vein with bare stents was selected over embolizing the arteriovenous fistula, leading to an excellent clinical outcome. Results and Conclusions: Acquired arteriovenous fistula should be considered in some patients with post-thrombotic syndrome. Endovascular recanalization without embolization of the arteriovenous fistula can effectively treat iliac vein thrombosis associated with arteriovenous fistula.

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Diagnosis and treatment of acquired arteriovenous fistula after lower extremity deep vein thrombosis

Cited by 12 publications

References 17 publications

Lower Extremity Arteriovenous Fistula Mimicking Deep Venous Thrombosis: A Case Report

Lower Extremity Arteriovenous Fistula Mimicking Deep Venous Thrombosis: A Case Report

Successful endovascular treatment with a stent graft for chronic deep vein thrombosis with multiple arteriovenous fistulas: a case report

Successful treatment of acquired arteriovenous fistula following iliac vein thrombosis

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