Large external iliac vein aneurysm in a patient with a post-traumatic femoral arteriovenous fistula

Abstract

We report about a young patient with a large aneurysm of the left external iliac vein associated with a traumatic arteriovenous fistula between the left superficial femoral artery and the femoral vein after a stab wound 20 years ago. The patient presented with swelling of the left leg, which developed during the past years and worsened after saphenectomy 12 months before hospital admission. The chronically hyperperfused common iliac artery proximal to the arteriovenous fistula was compressing the common iliac vein. The venous outflow obstruction and subsequent venous hypertension render a possible explanation for the formation of the iliac vein aneurysm. Surgical repair of the venous aneurysm by interposition grafting and closure of the arteriovenous fistula was successful. A postoperative computed tomography scan showed a 50% size reduction of the feeding artery, underlining the ability of the arterial system to normalize arterial diameter in response to flow reduction, even after a high flow situation had existed for probably >20 years.

Difficulties in the Management of Civilian Peripheral Vascular Trauma and their Complications at the University Teaching Hospital of Yaoundé, Cameroon

“…We found a reported case of arteriovenous fistula between brachial artery and vein comitans with an expansion of the artery rather than the vein as in our case [12]. Venous pseudoaneurysms are rarely reported in the literature [13].…”

Surgical Correction of a Pseudoaneurysm in Common Femoral artery and Arteriovenous fistula between Common Femoral artery and vein, Secondary to a stab injury - Experience in CMCH.

“…14 Treatment of peripheral arterial aneurysm and AVF includes ultrasound guided compression, ultrasound guided Thrombin Injection, 15 endovascular intervention 16 and surgery. 17 Surgery is associated with a higher initial success rate than other treatments and this benefit is maintained in follow-up. 17 With the increasing availability of DUS during the 1990s, less invasive treatment options using DUS-guidance gained popularity.…”

“…17 Surgery is associated with a higher initial success rate than other treatments and this benefit is maintained in follow-up. 17 With the increasing availability of DUS during the 1990s, less invasive treatment options using DUS-guidance gained popularity. Fellmeth et al in 1991 included ultrasound-guided compression (UGC) and percutaneous ultrasound-guided thrombin injection (UGTI) and proposed it as an alternative to surgery.…”

Aneurisma venoso gigante de veia ilíaca externa secundário a fístula arteriovenosa traumática: relato de caso

“…Over the past 90 years, sporadic cases of aneurysms of the superficial and deep venous systems have been reported in the world literature 1 . The external iliac vein is an infrequent site of those aneurysms 2 . The first case, reported by Hurwitz and Gelabert 1 in 1989, was a thrombosed common and external-iliac-vein aneurysm.…”

“…Symptoms of aneurysms result from the compression of pelvic structures, local thrombosis, thromboembolism and aneurysm rupture 2 .…”