Critical Limb Ischemia as a Consequence of Multiple Spontaneous Arteriovenous Fistulas and Peripheral Arterial Disease

DOI Web Site 参考文献9件 オープンアクセス
  • Yamashita Yutaro
    Department of Plastic and Reconstructive Surgery, Tokushima University Hospital
  • Yamasaki Hiroyuki
    Department of Plastic and Reconstructive Surgery, Tokushima University Hospital
  • Nagasaka Shinji
    Department of Plastic and Reconstructive Surgery, Tokushima University Hospital
  • Mineda Kazuhide
    Department of Plastic and Reconstructive Surgery, Graduate School of Biomedical Sciences, Tokushima University
  • Ishida Soshi
    Department of Plastic and Reconstructive Surgery, Graduate School of Biomedical Sciences, Tokushima University
  • Abe Yoshiro
    Department of Plastic and Reconstructive Surgery, Graduate School of Biomedical Sciences, Tokushima University
  • Hashimoto Ichiro
    Department of Plastic and Reconstructive Surgery, Graduate School of Biomedical Sciences, Tokushima University

書誌事項

タイトル別名
  • A Case Report

説明

Arteriovenous fistulas in the lower limbs are usually caused by trauma or surgical intervention and may sometimes be congenital. Furthermore, the occurrence of multiple spontaneous arteriovenous fistulas with peripheral artery disease is rare. Herein we describe a rare case of critical limb ischemia, generally caused by arteriosclerosis, with multiple spontaneous arteriovenous fistulas and peripheral artery disease.<br>An 83-year-old woman with a history of diabetes mellitus, hypertension, and diabetic nephropathy visited our hospital. An ulcer haddeveloped on her left first toe after surgery of an ingrown nail. She was diagnosed with critical limb ischemia due to decreased skin perfusion pressure in her lower leg. Angiography revealed multiple arteriovenous fistulas and severe peripheral artery disease. Below-knee amputation was initially ruled out because of lower leg ischemia. Thus, we first attempted partial ligation of the arteriovenous fistulas of the popliteal region to improve blood flow in the lower leg. Subsequently, we performed below-knee amputation without any complications. In conclusion, we were able to improve blood flow in the lower leg with partial arteriovenous fistula ligation surgery and preserved the knee joint.

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