Stent graft infixation after venous dislodgement in a patient with femoral posttraumatic arteriovenous fistula

Abstract

Introduction. An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein which may result from traumatic injury or may occur as congenital abnormality. Stent graft repair through arteriovenous fistula could lead to complications. Case report. Endovascular stent graft repair in a 23-year-old patient with posttraumatic superficial femoral arteriovenous fistula was performed to cover a fistula. During the procedure the device migrated through the fistula into the femoral vein. Due to eventual risk of migration to the heart, a prompt decision was made to fix the stent graft with three puncture needles in the common femoral vein region under fluoroscopy guidance. The vascular surgeon was called to perform open surgery. Conclusions. The presented way of treating this rare complication in an extreme and uncommon situation is very efficient, safe and inexpensive.Uvod. Arteriovenska fistula (AV) je abnormalni spoj izmedju arterije i vene i moze biti posledica povrede ili se pojavljuje kao kongenitalni defekt. Postavljanje stent-grafta preko AV fistule moze dovesti do komplikacija. Prikaz bolesnika. Prikazano je postavljanje endovaskularnog stent-grafta kod 23-godisnjeg bolesnika sa posttraumatskom superficijalnom femoralnom arteriovenskom fistulom u cilju pokrivanja fistule. Tokom procedure doslo je do migracije proteze kroz fistulozni kanal u femoralnu venu. Zbog moguceg rizika migracije u srce, donesena je brza odluka da se stentgraft fiksira punkcionim iglama u predelu femoralne vene pod vodjstvom fluoroskopije. Vaskularni hirurg je pozvan da izvrsi otvoreni hirurski zahvat. Zakljucak. Prikazani nacin resavanja retke komplikacije u ekstremnoj i neuobicajenoj situaciji je vrlo efikasan, siguran i jeftin.