Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 10, October, p. 1371–1375

doi: 10.17219/acem/69859

Publication type: original article

Language: English

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Endovascular treatment of iatrogenic arteriovenous fistula of the iliac vessel

Piotr Kaźmierski1,A,B,C,D,E,F, Mirosław Wąsiewicz1,B,C, Jarosław Chrząstek2,B,C, Michał Pająk1,D,E,F

1 Department of Vascular, General and Oncologic Surgery, Copernicus Memorial Hospital, Łódź, Poland

2 Department of Radiology, Copernicus Memorial Hospital, Łódź, Poland


Background. Iatrogenic vascular injuries, due to the particular nature of such pathology, are associated with high morbidity and mortality in the postoperative period.
Objectives. The objective of this study was to present a case of non-classic approach to the therapy of iatrogenic arteriovenous fistula.
Material and Methods. We present a case of a 17-year old female patient admitted to the Department of Vascular, General and Oncologic Surgery (Copernicus Memorial Hospital, Łódź, Poland) due to an iatrogenic injury to the common iliac vein and artery, following neurosurgical intervention on the spine. Two weeks prior to admission, the patient underwent surgery in the Neurosurgery Clinic for herniated nucleus pulposus and lumbar spine scoliosis. The imaging diagnostic revealed the presence of a pseudoaneurysm of the right common iliac artery and arteriovenous fistula between the right common iliac vessels. The patient was qualified for endovascular treatment. Two self-expanding covered stents were successfully deployed. The clinical and radiological outcome of the procedure was good. The postoperative period was uneventful. The patient was discharged home on the 3rd postoperative day.
Results. The control examinations (directly after the procedure and 6, 12, 24 and 32 months thereafter) revealed full patency of the iliac vessels, as well as no recurrence of arteriovenous fistula, nor a pseudoaneurysm of the right common iliac artery. No symptoms of either chronic limb ischaemia or venous insufficiency were observed.
Conclusion. Iatrogenic vessel injury, being a complication of neurosurgical and orthopedic surgeries, may be overlooked and remain undetected both in intraand postoperative period. Modern imaging techniques allow for an adequate diagnosis of the injury and planning the treatment of arteriovenous fistula. The endovascular procedures are the method of choice in patients with arteriovenous fistulas of iliac vessels, alternative to open surgery.

Key words

iatrogenic vessel injury, arteriovenous fistula, pseudoaneurysm of the common iliac artery, endovascular treatment

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