PMC6506916_01
CT angiogram in the arterial phase. Both common iliac veins are demonstrated
in this image - both have contrast present within them even though the
imaging has been performed in the arterial phase, and the right common iliac
vein in particular is grossly dilated. The right common iliac artery is
indicated by the arrow - it is clear that there is no plane between the
artery and the 'arterialised' venous system, consistent with the clinical
suspicion of an iatrogenic arteriovenous fistula.
10.1177_2050313X19847805-fig1.jpg
PMC6506916_01_10.1177_2050313X19847805-fig1.jpg
fig1-2050313X19847805
Appearances were highly suspicious of an ilio-iliac fistula (Figure 1).
Pre-deployment angiography demonstrates a large volume of contrast in the
inferior vena cava. In this image, the Amplatzer  plug can be seen in the
internal iliac artery origin and the Endurant  stent limb can be seen in the
common iliac/external iliac arteries ready to be released. In the
post-deployment image, the Endurant  stent graft limb is seen positioned
well in the origin of the common iliac artery, extending into the external
iliac artery - there is no contrast in the venous system demonstrated and
the internal iliac artery has been adequately managed.
10.1177_2050313X19847805-fig2.jpg
PMC6506916_01_10.1177_2050313X19847805-fig2.jpg
fig2-2050313X19847805
Angiography demonstrated a large fistula with almost the entire contrast passing into the venous system (Figure 2).