SURGICAL MANAGEMENT OF MULTIPLE POSTTRAUMATIC ARTERIOVENOUS FISTULAS OF FEMORAL VESSELS

Pokrovsky A.V., Shubin A.A., Kuntsevich G.I., Subbotin V.V., Suntsov D.S.
Department of Vascular Surgery,
State Federal Facility A.V. Vishnevsky Institute of Surgery,
Russian Federal Agency on HighTechnology Medical Care,
Moscow, Russia

Presented herein are two case reports concerning surgical management of posttraumatic arteriovenous fistulas of femoral vessels.

Case 1. A 45yearold female patient attended with a history of a shotgun injury wound of her left femur and crus sustained when a girl of eight. She sought medical attention for a progressively deteriorating condition, accompanied by pain, and breathlessness dyspnea at rest. Detected were multiple fistulas between the deep femoral artery and superficial femoral artery and femoral vein. Management consisted in separation of the arteriovenous fistulas, followed by prosthetic repair of the deep femoral artery.

Case 2. A 32yearold male patient after an accidentally inflicted shotgun injury of the his left femur underwent within a time period of 3 year three vascular operations including ligation of the deep femoral artery and femoral vein followed by having later on developed secondary lymphedema of his left lower limb and pronounced manifested chronic venous insufficiency. Management included dissociation of the numerous arteriovenous fistulas between the branches of the deep femoral artery and the common femoral artery, as well as bet ween the superficial femoral artery and femoral vein.

KEY WORDS: arteriovenous fistula, duplex scanning.

P. 145-154

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