Endovascular Treatment with Stentgraft for Common Iliac Arteriovenous Fistula

Abstract

The common iliac arteriovenous fistula (AVF) was previously performed by open surgery, but it was high risk due to the adhesions around the AVF and the possibility of massive bleeding because of hyper-vascularity. We herein report a case of endovascular repair of a common iliac AVF. An 84-year-old woman was admitted to our hospital because of left lower limb edema. She had a clinical history of abdominal total hysterectomy at age of 82 years. Enhanced computed tomography (CT) revealed an AVF between the right common iliac artery and the left common iliac vein. Because of the high risk of open surgery and severely frail, we conducted endovascular repair for the AVF using the GORE EXCLUDER stentgraft system. The first contralateral leg was deployed to occlude the right internal iliac artery, and the second leg was deployed over the aortic bifurcation to the right external iliac artery to seal the origin of the AVF. Postoperative enhanced CT confirmed occlusion of the AVF. The postoperative course was uneventful, and the left lower limb edema improved quickly.