A Case of Venous Reconstruction for Common Iliac Vein Occlusion and Ipsilateral Internal Iliac Arteriovenous Fistulae

DOI
  • Uehara Akifumi
    Department of Cardiovascular Surgery, Tachikawa Medical Center, Tachikawa General Hospital
  • Yamamoto Kazuo
    Department of Cardiovascular Surgery, Tachikawa Medical Center, Tachikawa General Hospital
  • Mishima Takehito
    Department of Cardiovascular Surgery, Tachikawa Medical Center, Tachikawa General Hospital
  • Sakakibara Kenji
    Department of Cardiovascular Surgery, Tachikawa Medical Center, Tachikawa General Hospital
  • Sugimoto Tsutomu
    Department of Cardiovascular Surgery, Tachikawa Medical Center, Tachikawa General Hospital
  • Yoshii Shinpei
    Department of Cardiovascular Surgery, Tachikawa Medical Center, Tachikawa General Hospital

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Other Title
  • 左総腸骨静脈閉塞と同側内腸骨動静脈瘻の合併に対する 1 治験例

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Description

The combination of common iliac vein occlusion and ipsilateral multiple internal iliac arteriovenous fistulae (AVF) is very rare. We report favorable results by venous reconstruction for this rare case. The patient was a 83-year-old woman, her chief complaint was painful left lower extremity swelling. Initially, a covered stent was implanted in the internal iliac artery to occlude the AVF, but only 1 month later, she was readmitted because of swelling of her left lower extremity and congestive heart failure. Operartion was performed, which consisted of division of left internal iliac artery, ligation of main left iliac AVF and bypass grafting between the left external iliac vein and inferior vena cava using a ringed ePTFE graft. Swelling of the left lower extremity and heart failure markedly improved. From her past history, the etiology of multiple AVF was neither traumatic nor iatrogenic, so we speculate that congenital and subclinical AVF was progressed by common iliac vein occlusion.

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