Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/jvb.2014.007
Jornal Vascular Brasileiro
Therapeutic Challenge

Treatment of acquired arteriovenous fistula with severe hemodynamic effects: therapeutic challenge

Tratamento de fístula arteriovenosa adquirida com repercussões hemodinâmicas graves: desafio terapêutico

Bruna Ferreira Pilan; Andréia Marques de Oliveira; Daniel Emílio Dalledone Siqueira; Ana Terezinha Guillaumon

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Abstract

A 34-year-old female patient with severe heart failure and pulmonary hypertension was diagnosed late with a high-output acquired arteriovenous fistula between the right common iliac vein and artery. The most probable cause was an iatrogenic vascular injury inflicted during a prior laparoscopic cholecystectomy. Treatment was conducted by placement of an endoprosthesis in the common iliac artery, achieving total exclusion of the fistula and complete remission of symptoms. Considering the options available for treating this type of lesion, endovascular techniques are becoming ever more effective and are now the option of first-choice for management of this pathology.

Keywords

arteriovenous fistula, endoprothesis, heart failure

Resumo

Paciente de 34 anos com quadro de insuficiência cardíaca e hipertensão pulmonar severas, com diagnóstico tardio de fístula arteriovenosa adquirida de alto débito entre a veia e a artéria ilíaca comum direita. A provável causa foi relacionada à lesão vascular iatrogênica em colecistectomia laparoscópica realizada previamente. O tratamento foi realizado com endoprótese em artéria ilíaca comum, resultando em exclusão total da fístula e remissão completa dos sintomas. Considerando-se as opções de tratamento para esse tipo de lesão, a técnica endovascular tem se mostrado cada vez mais eficaz e tem se tornado a primeira opção no manejo dessa patologia.

Palavras-chave

fístula arteriovenosa, endoprótese, insuficiência cardíaca

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