Covered Stent Grafts for Acquired Arterial Venous Fistulas: A Case Series

Ann Vasc Surg. 2018 Jan:46:369.e1-369.e5. doi: 10.1016/j.avsg.2017.08.029. Epub 2017 Sep 7.

Abstract

Background: Stent grafts have become the preferred method for treating abdominal aortic aneurysms (AAAs) but also have utility in treating other vasculopathies. In 2005, peripheral stent grafts were approved for treating superficial femoral artery occlusive disease. This report describes our experience using covered stent grafts to treat acquired arterial venous fistulae (aAVF).

Methods: We reviewed the records of patients treated for aAVF with covered stent grafts. Eleven patients had 12 limbs treated with a stent graft. The data collected included presenting symptoms, mechanism of injury, vessel location, stent graft used for therapy, and patency.

Results: Eleven patients underwent successful treatment of 12 aAVF with a peripheral stent grafts. The average age was 55.6 (18-87), and there were 4 women and 7 men. The mechanisms of injuries were heart catheterization in 5 patients, penetrating trauma in 3 patients, and orthopedic injury in 3 patients. Five of the patients had concurrent pseudoaneurysms. Self-expanding expanded polytetrafluoroethelene (ePTFE) stent grafts were used in 8 patients, and balloon-expandable ePTFE stent grafts were used in 3 patients. Primary patency at 2 years is 100%, with all patients having significant relief of symptoms.

Conclusions: Peripheral stent grafts are a useful tool for treating aAVF, with excellent patency. They provide a valuable minimally invasive approach to this disease.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / etiology
  • Arteriovenous Fistula / physiopathology
  • Arteriovenous Fistula / surgery*
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Computed Tomography Angiography
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Iatrogenic Disease*
  • Male
  • Middle Aged
  • Phlebography / methods
  • Polytetrafluoroethylene
  • Prosthesis Design
  • Retrospective Studies
  • Stents*
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Vascular Patency
  • Vascular System Injuries / diagnostic imaging
  • Vascular System Injuries / etiology
  • Vascular System Injuries / physiopathology
  • Vascular System Injuries / surgery*

Substances

  • Polytetrafluoroethylene