Traumatic Arteriovenous Fistula Treated by PTFE Stent Graft: A Case Report

ABSTRACT

Since the first description of arteriovenous fistula (AVF) secondary to lumbar disc surgery by Linton and White in 1945, many cases of the accidental injury to the great vessels anterior to the lumbar area have been reported. We experienced a unique case of AVF between the internal iliac artery and internal iliac vein following disc surgery. Diagnosis of traumatic AVF in a patient with multiple varicose dilatation of vein in the left thigh and inguinal area was heralded by the presence of unique, unusual arterial signals in the area of dilated veins during the leg Doppler scan. 3D-CT angiography clearly confirmed the presence of a fistular tract between the internal iliac artery and vein. Using the Seldinger technique, a PTFE stent graft was inserted into the internal iliac artery to cover the fistular site nonsurgically. After the procedure, venous dilatation decreased and the patient felt comfortable. Follow-up 3D-CT angiography one month after procedure showed complete obliteration of fistuar tract and patent blood flow through PTFE stent graft in the internal iliac artery.