Zan Carlos Eduardo Barbosa, Menezes Fábio Husemann
Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil.
J Vasc Bras. 2025 Jul 30;24:e20230177. doi: 10.1590/1677-5449.202301772. eCollection 2025.
We report the case of a 38-year-old man with a traumatic arteriovenous fistula between the left common femoral artery and vein, resulting from a gunshot wound sustained 20 years earlier. He began presenting symptoms, including a venous stasis ulcer and cardiac dysfunction, 4 years ago. Computed tomography revealed the presence of a fistula and downstream dilation of the iliac vessels and inferior vena cava, the latter measuring up to 37.5 mm. Given the patient's complex vascular anatomy and overall good clinical condition, an open surgical approach was selected, resulting in excellent outcomes. Due to the risk of deep vein thrombosis and pulmonary thromboembolism, placement of an inferior vena cava filter and initiation of long-term anticoagulation were also performed. Surgery proved to be the definitive treatment, resolving both heart failure and ulcer, and restoring the patient's quality of life. The open approach was an excellent treatment option, considering the patient's young age, anatomical distortion, and the unavailability of adequate endovascular materials.
我们报告了一例38岁男性患者，其左股总动静脉之间存在创伤性动静脉瘘，病因是20年前遭受的枪伤。他在4年前开始出现症状，包括静脉淤滞性溃疡和心脏功能障碍。计算机断层扫描显示存在瘘管以及髂血管和下腔静脉下游扩张，后者直径达37.5毫米。鉴于患者复杂的血管解剖结构和总体良好的临床状况，选择了开放手术方法，取得了极佳的效果。由于存在深静脉血栓形成和肺血栓栓塞的风险，还放置了下腔静脉滤器并开始长期抗凝治疗。手术被证明是决定性的治疗方法，解决了心力衰竭和溃疡问题，恢复了患者的生活质量。考虑到患者年轻、解剖结构扭曲以及缺乏合适的血管内材料，开放手术方法是一个极佳的治疗选择。
