Repair of a combined femoral pseudoaneurysm and arteriovenous fistula using a covered stent graft.

ABSTRACT

Our purpose was to demonstrate clinical efficacy of covered stent use in the peripheral vasculature. A 68-year-old man was transferred from an outlying hospital for evaluation and treatment of a pulsatile mass in his right groin after cardiac catheterization. Imaging with duplex ultrasound and diagnostic arteriogram demonstrated a 6-cm pseudoaneurysm (PSA) of the right superficial femoral artery (SFA) and an arteriovenous fistula (AVF) of the SFA and the profunda vein. Using a covered stent extending from the proximal SFA across the origins of the AVF and PSA, complete exclusion was attained. Follow-up ultrasound at 6 weeks revealed a patent stent, no AVF, and thrombosis of the PSA. Endovascular treatment of peripheral lesions (AVF/PSA) in an elective to semi-elective setting offers patients a safe, less invasive treatment option to consider over traditional open surgery. Consequently, a formidable reduction in incision length, wound infection, and postoperative immobility can be expected.