The Occurrence of Arterio-venous Fistula during Lower Limb Subintimal Angioplasty: Treatment and Outcome

Objectives

To describe our experience with iatrogenic arterio-venous fistula (AVF) occurring during lower limb subintimal angioplasty, their management and the final clinical, radiological outcome.

Design

Retrospective review of case series from two centres, from a computerised database over a period of five years.

Material

Twelve patients whose lower limb subintimal angioplasty was complicated by Iatrogenic AVF.

Results

The Majority of AVF occurred at the popliteal trifurcation vessels. And the incidence of this complication in our case series was 0.8%. This was managed with a variety of techniques-Coil embolisation, balloon tamponade, alternative dissection and stent placement. In one patient, the fistula was left open intentionally. All twelve patients had a successful angioplasty. The overall technical success rate for AVF ablation was eighty percent.

Conclusions

AVF is a potential complication of angioplasty. The majority can be managed by endovascular means during the angioplasty procedure with good technical success.

Keywords: Subintimal angioplasty, AV fistula

Abbreviations: AVF – Arterio-venous Fistula, SIA – Subintimal Angioplasty