Ulcers associated with arteriovenous fistula within a Stewart-Bluefarb syndrome:: arterial and/or venous therapy?

Ulcers associated with arteriovenous fistula within a Stewart-Bluefarb syndrome: arterial and/or venous therapy? We report on a 46-year old female patient with a 2-year history of ulceration over the dorsum of her right foot associated with a congenital arteriovenous fistula. About 12 years ago she had an ulcer at the same site. Despite an insufficient occlusion of the arteriovenous fistula after coil-embolization complete healing of the ulcer was achieved for a period of 10 years. At present hyperpigmentation could be seen surrounding the ulcer as a clinical sign for a venous insufficiency. The ulcer healed completely under a conservative therapy of the venous component of the arteriovenous fistula. The pathogenesis and therapy of ulcers associated with arteriovenous fistula within a Stewart-Bluefarb syndrome are discussed in this case report.