The occurrence of arterio-venous fistula during lower limb subintimal angioplasty: Treatment and outcome

Objectives. To describe our experience with iatrogenic arterio-venous fistula (AVF) occurring during lower limb subintimal angioplasty, their management and the final clinical, radiological outcome. Design. Retrospective review of case series from two centres, from a computerised database over a period of five years. Material. Twelve patients whose lower limb subintimal angioplasty was complicated by latrogenic AVF Results. The Majority of AVF occurred at the popliteal trifurcation vessels. And the incidence of this complication in our case series was 0.8%. This was managed with a variety of techniques-Coil embolisation, balloon tamponade, alternative dissection and stent placement. In one patient, the fistula was left open intentionally. All twelve patients had a successful angioplasty. The overall technical success rate for AVF ablation was eighty percent. Conclusions. AVF is a potential complication of angioplasty. The majority can be managed by endovascular means during the angioplasty procedure with good technical success.