Porter J, Al-Jarrah Q, Richardson S
Department of Vascular Surgery, University Hospital of South, Manchester, Southmoor Road, Manchester M23 9LT, UK.
Case Rep Vasc Med. 2014;2014:510429. doi: 10.1155/2014/510429. Epub 2014 May 20.
Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally diagnosed as chronic fatigue syndrome. Following clinical examination, duplex ultrasound, and CT angiography a significant arteriovenous fistula was confirmed. Elective open surgery was performed, leading to a dramatic and rapid improvement in symptoms. Femoral arteriovenous fistulas have the potential to cause significant haemodynamic effects and can present many years after the initial procedure. Conservative, endovascular, and open surgical management strategies are available.
经皮动脉插管常用于一系列诊断和介入手术。医源性股动静脉瘘是这些手术罕见的并发症。大多数无症状且可自行闭合，但极少数情况下瘘口大小会增加并导致症状出现。我们报告一例医源性股动静脉瘘病例，该病例导致一名34岁马拉松运动员的充血性心力衰竭加重。该患者最初被诊断为慢性疲劳综合征。经过临床检查、双功超声和CT血管造影，确诊存在明显的动静脉瘘。实施了择期开放手术，症状得到显著且迅速的改善。股动静脉瘘有可能引起显著的血流动力学影响，并且可在初次手术后数年出现。目前有保守、血管腔内和开放手术等治疗策略。
