PMC9249528_01
Duplex ultrasound showing an abnormally shaped AV fistula with associated pseudoaneurysm.
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fig1
Duplex ultrasound was performed for imaging (Figure 1).
Dissection of the arteriovenous fistula and pseudoaneurysm (white borders). Top left is the inguinal ligament, orange borders highlight the common femoral artery, and blue borders highlight femoral vein.
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Surgical exposure identified a common femoral artery to femoral vein AVF with PSA, shown in Figure 2, with contributing branches identified (Figures 2 and 3).
Views of the arterial and venous connections to the structure. (a) Arterial connection to AV fistula and pseudoaneurysm. (b) Venous connection to AV fistula and pseudoaneurysm.
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fig3
Surgical exposure identified a common femoral artery to femoral vein AVF with PSA, shown in Figure 2, with contributing branches identified (Figures 2 and 3). The AVF and PSA were mobilized along with obtaining distal artery and vein control (Figure 3).
Repair of the AV fistula with pseudoaneurysm. (a) Suture ligation of the venous limb of the structure with AV fistula/pseudoaneurysm remnant. (b) Repaired AV fistula/pseudoaneurysm prior to closing. The common femoral artery is at the top with a great saphenous vein patch sewn in. The femoral vein is at the bottom with the stump ligated.
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fig4
The venous end was suture ligated, observing a small opening into the vein (Figure 4). The fistula then divided from the artery and a harvested saphenous vein was sewn to the artery (Figure 4).