Same features, different diagnosis: A case of ilio-iliac arteriovenous fistula presenting as decompensated heart failure

Abstract

In case of high output cardiac failure, an arteriovenous fistula should be considered.

Endovascular treatment of an ilio-iliac arteriovenous fistula accompanied by venous thromboembolism presenting with multiple organ failure – A case report and literature review

“…7,8 A variety of symptoms appear depending on the size and location of AVF. 9,10 Given that the fistula of ilio-iliac segment was away from aorta and IVC, its blood flow volume is smaller than aortocaval fistula. Thus, an ilio-iliac AVF presenting with systematic symptoms is rare.…”

“…1,11 We searched literatures since 1999 by using PubMed, and found only two patients with ilio-iliac AVF presenting multi-organ dysfunction. 10,12 However, both of them had an extensive fistula orifice, which demonstrated that ilio-iliac AVF may be fatal with specifically unfavorable anatomy.…”

“…The severe venous hypertension and congestive heart failure can cause pulmonary arterial hypertension, which lead to pneumoedema and respiratory failure. 10–12 In such patients, acute renal failure may occur as a result of unusual high renal congestion due to venous hypertension. 13,14 Furthermore, heart failure and associated hypoperfusion may lead to pre-renal failure.…”

“…MOF was reversible when fistula was excluded, and EVT could reduce the mortality for patients with poor conditions. 10,12 As right internal iliac artery was derived from CIAA, it was embolized with coils before stent deployment. However, persistent communication between aneurysm sac and venous system occurred due to type II endoleak from lumbar artery.…”