Chronic traumatic popliteal arteriovenous fistula

Case contributed by Dr Vardan Abrahamyan
Diagnosis almost certain

Presentation

A year ago trauma, after then swollen and pulsating lump in the distal left thigh.

Patient Data

Age: 30 years
Gender: Male

Arteriovenous connection at P1 level of the popliteal artery via pseudoaneurysm. Superficial varicose veins of the left lower extremity, dilatation of the femoral, iliac veins, and IVC, and early contrast enhancement.

Case Discussion

Traumatic arteriovenous fistula usually results from penetrating injury to nearby arteries and veins. Arterial blood with higher pressure flows into a vein with lower pressure. Fistulas can cause significant hemodynamic deviation.

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