Treatment of acquired arteriovenous fistula with severe hemodynamic effects: therapeutic challenge

A 34-year-old female patient with severe heart failure and pulmonary hypertension was diagnosed late with a high-output acquired arteriovenous fistula between the right common iliac vein and artery. The most probable cause was an iatrogenic vascular injury inflicted during a prior laparoscopic chole...

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Published inJornal vascular brasileiro Vol. 13; no. 1; pp. 34 - 38
Main Authors Pilan, Bruna Ferreira, Oliveira, Andréia Marques de, Siqueira, Daniel Emílio Dalledone, Guillaumon, Ana Terezinha
Format Journal Article
LanguageEnglish
Published Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 01.03.2014
Subjects
CARDIAC & CARDIOVASCULAR SYSTEMS
endoprótese
fístula arteriovenosa
insuficiência cardíaca
PERIPHERAL VASCULAR DISEASE
SURGERY
heart failure
insuficiência cardíaca
fístula arteriovenosa
arteriovenous fistula
endoprótese
endoprothesis
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Summary:A 34-year-old female patient with severe heart failure and pulmonary hypertension was diagnosed late with a high-output acquired arteriovenous fistula between the right common iliac vein and artery. The most probable cause was an iatrogenic vascular injury inflicted during a prior laparoscopic cholecystectomy. Treatment was conducted by placement of an endoprosthesis in the common iliac artery, achieving total exclusion of the fistula and complete remission of symptoms. Considering the options available for treating this type of lesion, endovascular techniques are becoming ever more effective and are now the option of first-choice for management of this pathology. Paciente de 34 anos com quadro de insuficiência cardíaca e hipertensão pulmonar severas, com diagnóstico tardio de fístula arteriovenosa adquirida de alto débito entre a veia e a artéria ilíaca comum direita. A provável causa foi relacionada à lesão vascular iatrogênica em colecistectomia laparoscópica realizada previamente. O tratamento foi realizado com endoprótese em artéria ilíaca comum, resultando em exclusão total da fístula e remissão completa dos sintomas. Considerando-se as opções de tratamento para esse tipo de lesão, a técnica endovascular tem se mostrado cada vez mais eficaz e tem se tornado a primeira opção no manejo dessa patologia.
ISSN:1677-5449
1677-7301
1677-7301
DOI:10.1590/jvb.2014.007