PMC7339078_01
Venous duplex Doppler examination: (a) The blood flow shows an arterial flow pattern.
(b) The white arrow indicates arteriovenous fistulas. (c) The blood flow shows an
arterial flow pattern again. (d) The white arrow indicates mild stenosis in the common
iliac vein.
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Ultrasound showed no DVT, but the arterial flow pattern indicated venous blood flowing back into the toe (Figure 1(a)) and diffuse iliac AVFs (Figure 1(b)).
Angiography of the lower left extremity: (a) Arteriovenous fistulas in the common iliac
artery and vein. (b) Arteriovenous fistulas in the internal iliac artery and vein. (c)
The common iliac vein was occluded. (d) The left common iliac vein was patent.
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Lower left extremity angiography showed the presence of multiple AVFs in the common and internal iliac arteries (Figure 2(a) and (b)) and the occluded common iliac vein (Figure 2(c)). Balloon angioplasty was performed, and anterograde blood flow and sufficient acute gain were obtained (Figure 2(d)).