Percutaneous Closure of Side-to-Side Femoral Arteriovenous Fistula Using Untied Suture

Side-to-side femoral arteriovenous fistulas are not amenable to closure with embolization, and surgical repair remains the traditional treatment. A 16-month-old boy presented with swelling in his right lower extremity, a complication arising from a side-to-side arteriovenous fistula that developed after cardiac catheterization at 5 months of age. The iatrogenic fistula was effectively closed using a simple technique involving disruption of the fistula with a curved needle and the placement of a transfistula untied suture under sonographic guidance. A follow-up visit 4 years later indicated the fistula remained obliterated.