Long-standing traumatic femoro-femoral arteriovenous fistula presenting with congestive cardiac failure after 35 years

Abstract

Acquired arteriovenous fistulas (AVFs) could either be traumatic or iatrogenic, though a spontaneous etiology was described by Syme in 1831. Penetrating injuries from stab wounds account for a large proportion of civilian cases of traumatic AVFs. Chronic or long-standing AVFs are characterized by significant shunting of blood from the arterial to the venous system. We report a case of a large traumatic femoral AVF, presenting with features of congestive cardiac failure (CCF), in a 54-year-old male after a remote stab injury to the right groin. The patient had also developed signs of unilateral chronic venous insufficiency in the involved limb. Following clinical examination, duplex ultrasound, and computed tomography angiography, the diagnosis of chronic AVF was confirmed. He successfully underwent open surgical repair with a dramatic resolution of symptoms of CCF.