[Endovascular treatment of post-traumatic arteriovenous fistulae]

To summarize the experience of endovascular treatment of traumatic arteriovenous fistulae.

Endovascular interventions for arteriovenous fistulae of different locations were applied in 16 patients aged 19 to 83 years (mean 50.4±14.3) in A.V. Vishnevskiy Institute of Surgery from 2003 to 2014. Among causes there were stab wounds, gunshot wounds, blunt trauma, iatrogenic. Different endovascular methods including stenting with self-opening and balloon-expanding stent-grafts, embolic coils and occluders implantation were used.

Pain syndrome, disorders of support function and trophic changes were observed in patients with arteriovenous fistulae more localized more distal than lower one third of the thigh. More proximally located arteriovenous fistulae regardless of their diameter resulted severe heart failure and portal hypertension. Angiographic and clinical success was achieved in 100% of cases. Manifestations of heart failure and portal hypertension disappeared in all patients after endovascular interventions. Also support function restored, pain and trophic disorders were cured.

Arteriovenous fistulae regardless of their size, location and time of existence must be dissociated. Prolonged arteriovenous shunting leads to severe heart failure. Current technologies and tools used in endovascular interventions provide reliable dissociation of arteriovenous fistulae even in case of difficult anatomical features.