A Case of Traumatic Popliteal Arteriovenous Fistula Resulting in a Giant Iliac Venous Aneurysm

Masato Yoshikawa Yuji MiyamotoMasataka Mitsuno
Masao Yoshitatsu Kenji Onishi

(Department of Cardiovascular Surgery, Sakurabashi-Watanabe Hospital, Osaka, Japan)

A 70-year-old woman presented with extending varicose veins of her left lower extremity. Seventeen years previously she suffered a stab wound in her left lower extremity. She had a thrill in her left groin and a pulsatile mass in her lower abdomen on the left side. Venography showed ‘to and fro' sign in her popliteal vein. Arteriography and computed tomography (CT) scan revealed left popliteal arteriovenous fistula and dilated femoral artery and vein, in addition to a giant iliac venous aneurysm (9cm in diameter). The shunt ratio was calculated at 3.4. We separated the fistula using ringed ePTFE grafts. After the operation, her varicose veins remarkably diminished. CT scans showed that the iliac venous aneurysm diminished to 3.6cm with no internal thrombus at three weeks after the operation. Cases of traumatic arteriovenous fistula with venous aneurysm that occurred in parts other than the fistula are rare and there are only two cases in the international literature. 
 Jpn. J. Cardiovasc. Surg. 31:285-287 (2002)