Arteriovenous fistula after endovenous laser treatment of the short saphenous vein.
Timperman PE.
Source
Arnett Clinic, 2600 Greenbush Avenue, Lafayette, Indiana 47904, USA.
paultimperman@verizon.netAbstract
Reports of major complications from endovenous laser treatment of saphenous veins with use of perivenous tumescent anesthesia are very rare. The author reports a major complication of endovenous laser treatment, the creation of an arteriovenous (AV) fistula. The fistula was created between the short saphenous vein (SSV) and the superficial sural artery in the popliteal fossa during endovenous laser treatment of the SSV. The proximity of the superficial sural artery and the SSV in the popliteal fossa increases the risk of fistula formation. Color-flow Doppler ultrasonography can demonstrate potentially dangerous anatomic relationships between the vein segment intended for treatment and adjacent arteries. Recognition of these relationships should increase the operator's ability to minimize the risk of AV fistula formation.
J Vasc Interv Radiol. 2004 Jun;15(6):625-7.
PMID:15178724 [PubMed - indexed for MEDLINE]
Eur J Vasc Endovasc Surg. 2009 Aug;38(2):234-6. Epub 2009 Jun 12.
Arterio-venous fistula following endovenous laser ablation for varicose veins.
Theivacumar NS, Gough MJ.
Source
Leeds Vascular Institute, The General Infirmary at Leeds, Leeds LS1 3EX, UK.
Abstract
Endovenous laser ablation (EVLA) obliterates incompetent truncal veins as an alternative to varicose veins surgery. We describe 3 patients who developed an arterio-venous fistula (AVF) following great (GSV: 1) or small (SSV: 2) saphenous vein EVLA. Two fistulae closed spontaneously with conservative management. Concomitant venous and arterial wall thermal injury or needle trauma during administration of tumescent anaesthesia may cause this rare complication. Haemodynamic effects appear minimal and spontaneous closure is likely, supporting a non-interventional policy.
PMID:
19524461
[PubMed - indexed for MEDLINE]
Ann Vasc Surg. 2009 May-Jun;23(3):412.e15-7. Epub 2008 Oct 29.
Iatrogenic arteriovenous fistula following endovenous laser therapy of the short saphenous vein.
Vaz C, Matos A, Oliveira J, Nogueira C, Almeida R, Mendonça M.
Source
Vascular Surgery Department, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal.
carolina_vaz@aeiou.ptAbstract
Short saphenous vein incompetence is present in up to 20% of patients with varicose veins. Studies looking at the success and complication rates associated with endovenous laser ablation of the short saphenous vein included only a small number of patients. The authors report the case of a 51-year-old woman presenting with a painful right leg edema. She had a history of previous endovenous laser ablation of the right and left great saphenous veins and right short saphenous vein. Duplex scan was performed and showed an arteriovenous fistula between branches of the popliteal artery and vein. Surgical ligation of the fistula was performed. At 8-month follow-up, the patient remains asymptomatic.
PMID:
18973984
[PubMed - indexed for MEDLINE]
J Vasc Surg. 2010 Mar;51(3):715-9. Epub 2010 Jan 25.
A case of external iliac arteriovenous fistula and high-output cardiac failure after endovenous laser treatment of great saphenous vein.
Ziporin SJ, Ifune CK, MacConmara MP, Geraghty PJ, Choi ET.
Source
Department of Surgery, Washington University School of Medicine, St Louis, MO 63110, USA.
Abstract
Valvular incompetence in the great saphenous vein (GSV) is the most common cause of superficial venous insufficiency and symptomatic varicose vein development. Recently, less invasive modalities such as foam sclerotherapy, radiofrequency ablation (RFA), and endovenous laser treatment (EVLT) have gained popularity in the treatment of saphenofemoral junction and saphenous truncal incompetence over the traditional approach of surgical ligation and stripping. Here, we present the case of a 32-year-old woman who underwent EVLT and was diagnosed subsequently with ipsilateral external iliac arteriovenous (AV) fistula and high-output cardiac failure. She was stabilized medically and treated surgically with a covered stent placed in the external iliac artery with complete resolution of the fistula and cardiac failure. We reviewed the literature and discuss the complications of AV fistulae after EVLT.
PMID:
20100645
[PubMed - indexed for MEDLINE]
Cardiovasc Intervent Radiol. 2009 Jan;32(1):166-8. Epub 2008 May 28.
Treatment of an unusual complication of endovenous laser therapy: multiple small arteriovenous fistulas causing complete recanalization.
Yildirim E, Saba T, Ozulku M, Harman A, Aytekin C, Boyvat F.
Source
Department of Radiology, Baskent University Medical School, Selcuklu, Konya, Turkey.
drerkany@yahoo.comAbstract
A 67-year-old woman was admitted to our institution with pain, night cramping, and visible varicose veins on her left leg. Doppler ultrasonography revealed continuous reflux in the great saphenous vein when the patient did the Valsalva maneuver. Endovenous laser therapy was applied to the great saphenous vein. Doppler ultrasonography 7 days later showed recanalization of, and arterialized flow in, the great saphenous vein. There also were small arterial vessels adjunct to the recanalized side. A left femoral angiography via a right femoral approach showed multiple small arteriovenous fistulas between superficial femoral artery muscle branches and the great saphenous vein. A second endovenous laser treatment was done at 80 J/cm, but the recanalization persisted. We offered to treat this endovascularly, but the patient preferred a surgical option. To the best of our knowledge, this is the first report of the demonstration of such a complication with endovenous laser therapy.
Comment in
• Cardiovasc Intervent Radiol. 2010 Feb;33(1):227-8.
PMID:
18506521
[PubMed - indexed for MEDLINE]
Volume 23, Issue 3, Pages 412.e15-412.e17 (May 2009)
Iatrogenic Arteriovenous Fistula Following Endovenous Laser Therapy of the Short Saphenous Vein
Carolina Vaz , Arlindo Matos, João Oliveira, Clara Nogueira, Rui Almeida, Mergulhão Mendonça
published online 29 October 2008.
Short saphenous vein incompetence is present in up to 20% of patients with varicose veins. Studies looking at the success and complication rates associated with endovenous laser ablation of the short saphenous vein included only a small number of patients. The authors report the case of a 51-year-old woman presenting with a painful right leg edema. She had a history of previous endovenous laser ablation of the right and left great saphenous veins and right short saphenous vein. Duplex scan was performed and showed an arteriovenous fistula between branches of the popliteal artery and vein. Surgical ligation of the fistula was performed. At 8-month follow-up, the patient remains asymptomatic.
Vascular Surgery Department, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal
Correspondence to Dr. Carolina S. Vaz, Centro Hospitalar do Porto, Cirurgia Vascular, Largo Professor Abel Salazar, Oporto, Portugal
PII: S0890-5096(08)00311-7
doi:10.1016/j.avsg.2008.08.010
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