[Traumatic arteriovenous fistulas during a period of peace]

The aim of the study was to point out the significance of clinical vascular examination and angiography in diagnosis setting, with the presentation of the patients treated for traumatic arteriovenous (AV) fistulas, so as the significance of timely treatment of that specific traumatic entity. In the period 1985-1996 11 patients with traumatic AV fistulas were treated. The most frequent causes of injury were bullet from firearms and blunt injury. The most frequent injury localization was in upper leg (4 cases). The interval from injury till registration and/or treatment of AV fistula was from 10 days to 33 years. Murmur was noticed in nine patients, thrill in eight, and weakened or absent arterial pulsations below the place of injury were observed in five patients. The diagnosis was confirmed by classic or cine-angiography. Major blood vessels were surgically reconstructed by various techniques, and non-major were ligated or percutaneous transluminal embolization was used. It was concluded that the noticing of murmur and thrill above the place of injury pointed out the existence of traumatic AV fistula, and angiography represented reliable diagnostic method and should be used for diagnostic, as well as therapeutic purposes. In the case of major blood vessel injury, surgical reconstruction is the method of choice.