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Spontaneous iliac arteriovenous fistula
C Morrow1, C Lewinstein, Y Ben-Menachem
1Department of Surgery, Baylor College of Medicine, Houston, TX.
Journal of Vascular Surgery
|November 1, 1987
Summary
Ruptured atherosclerotic iliac artery aneurysms rarely cause iliac arteriovenous fistulas. Early recognition of symptoms like abdominal masses, bruits, and leg swelling is crucial for prompt surgical intervention and successful management.
Area of Science:
- Vascular Surgery
- Atherosclerosis Research
- Arteriovenous Fistula Studies
Background:
- Iliac arteriovenous fistulas (AVFs) resulting from ruptured atherosclerotic iliac artery aneurysms are rare vascular events.
- This study reviews 18 previously reported cases alongside a new case presentation.
Observation:
- Key clinical signs include a palpable abdominal mass, pulsatile thrill or bruit, and unilateral leg symptoms (venous engorgement or arterial insufficiency).
- Acute onset of congestive heart failure may also be present.
- These symptoms warrant a high index of suspicion for iliac AVF.
Findings:
- The primary finding is the unusual association between atherosclerotic iliac artery aneurysm rupture and the formation of an iliac AVF.
- The review consolidates clinical presentations and outcomes from existing literature.
Implications:
- Prompt diagnosis and surgical closure of the fistula are critical for effective patient management and improved outcomes.
- Increased clinical awareness of this rare condition is essential for timely intervention.
- Understanding the clinical presentation aids in differentiating AVF from other abdominal pathologies.