Abstract
An 81-year-old man, who complained of a swollen left leg, was referred to our hospital. Enhanced computed tomography of the abdominal area and lower extremities showed abdominal aortic and bilateral iliac arterial aneurysms with an arteriovenous (AV) fistula extending from the right common iliac artery to the left common iliac vein. A shunt was observed on abdominal ultrasonography extending from the right common iliac artery to the left common iliac vein with a fistula of 14 mm in diameter. Further ultrasonography on admission revealed thrombosis in the external iliac and femoral veins on the left side. On a diagnosis of abdominal aortic and bilateral iliac arterial aneurysms with AV fistula from the right common iliac artery to the left common iliac vein with deep-vein thrombosis, we performed a Y-shaped vascular graft replacement (Intergard, 16 mm×8 mm) and simple closure of the AV fistula by manual compression, after insertion of a temporary inferior vena cava filter. We obtained good surgical results with the preoperative identification and localization of the AV fistula.
