Hoshino Yuji, Yokoi Hiroyoshi
Section of Vascular Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan.
Cardiovascular Medicine Center, Fukuoka Sanno Hospital, Fukuoka, Japan.
J Vasc Surg Cases Innov Tech. 2022 Aug 19;8(4):629-633. doi: 10.1016/j.jvscit.2022.08.004. eCollection 2022 Dec.
The post-thrombotic syndrome is a serious complication of deep vein thrombosis. Post-thrombotic iliac venous occlusion (PTIVO) is rarely associated with an arteriovenous fistula (AVF); however, the underlying mechanism remains unclear. We reported three PTIVO cases associated with an AVF, two symptomatic cases treated with venous stenting, and one asymptomatic case followed up conservatively. The essential imaging findings to diagnose PTIVO with an AVF were the presence of an arterial waveform on ultrasound examination and early opacification on contrast-enhanced computed tomography in the iliofemoral veins. Venous stenting resulted in the disappearance of the AVF, drastic improvement in symptoms, and an excellent long-term outcome.
血栓形成后综合征是深静脉血栓形成的一种严重并发症。血栓形成后髂静脉闭塞(PTIVO)很少与动静脉瘘(AVF)相关;然而,其潜在机制仍不清楚。我们报告了3例与AVF相关的PTIVO病例,其中2例有症状的病例接受了静脉支架置入治疗,1例无症状病例进行了保守随访。诊断伴有AVF的PTIVO的关键影像学表现是超声检查时出现动脉波形以及髂股静脉在对比增强计算机断层扫描上早期显影。静脉支架置入导致AVF消失,症状显著改善,长期预后良好。