Images in internal medicine
A 20-year femoral arteriovenous fistula
JORGE IGNACIO MAGAÑA-REYESa
LUIS GERARDO DOMÍNGUEZ-CARRILLOb
*
a Especialista en Radiología e Imagenología, Gestalt Imagen; Guanajuato (México).
b Especialista en Medicina de Rehabilitación. Catedrático Facultad de Medicina de León, Universidad de Guanajuato. Guanajuato (México).
This was a 42-year-old male who underwent surgery for transposition of the great arteries as a child. Twenty years later a catheterization through the right deep femoral artery was performed. Over the last five years he has had edema with a change in color of his right foot 50 seconds after going from a lying to a standing position (Figure 1). Computed tomography angiography corroborated the diagnosis of an arteriovenous fistula (AVF) in the right femoral system (Figures 2 and 3). He was referred to vas cular surgery for stent placement.
Diagnostic and therapeutic percutaneous catheterization techniques entail a risk of vascular complications such as AVF, false aneurysms, hematomas, hemorrhages and arterial thromboses, with an incidence of 0.5% to 1% after diagnostic procedures; 0.0-9% after balloon angioplasty; 5.7-17% after stent implantation and 5.2-10% after percu taneous mitral vavuloplasty 1,2. Covered stents are used to resolve the AVFs 3.
References
1 - Alonso M, Tascón J, Hernández F, Andrue J, et al. Complicaciones del acceso femoral en el cateterismo cardíaco: impacto de la angiografía femoral sistemática previa y la hemostasia con tapón de colágeno VasoSeal-ES. Rev Esp Cardiol 2003; 56: (6) 569-577. DOI: 10.1157/13048154.
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2 - Maynar J, López ZF, Castaño S, Iturbe M, Barrasa H, et al. Catéteres de arteria y de vena femoral: complicaciones relacionadas con su inserción y alter nativas técnicas para evitarlas. Medintensiva 2013; 37: 369-371. DOI: 10.1016/j.medin.2013.03.010.
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3 - Alvarado AL, Romero CJ, López HC, Peralta LJ. Manejo endovascular de fístula arteriovenosa postraumática. Rev Sanid Mil. 2018; 72: 351-354.
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