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Endovascular Repair of a Large Ilioiliac Fistula Using a Reversed Iliac Limb Endograft

Nikolaos Konstantinou1, Tilo Kölbel1, Fiona Rohlffs1

  • 1Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, Hamburg, Germany.

Annals of Vascular Surgery
|December 1, 2018
PubMed

Insights

Iliac artery and vein fistulas are rare, challenging conditions. Endovascular stent graft treatment offers a successful first-line therapy option for these rare arteriovenous fistulas.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Medical Device Technology

Background:

  • Iliac artery and vein fistulas are uncommon and difficult to diagnose and treat.
  • High-flow fistulas can lead to significant complications such as heart failure.

Observation:

  • A 74-year-old patient presented with heart failure due to a high-flow fistula between the left common iliac artery and the ipsilateral common iliac vein.
  • The fistula was likely iatrogenic, resulting from prior prostatic surgery.

Findings:

  • Computed tomography angiography revealed the ilioiliac fistula.
  • Successful endovascular treatment was achieved using two back-table reversed stent grafts.

Implications:

  • Endovascular therapy is a viable and effective first-line treatment for ilioiliac fistulas.
  • This approach offers satisfactory results for a rare but serious vascular condition.
  • Minimally invasive techniques should be considered for managing iatrogenic arteriovenous fistulas.

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