Acquired Arteriovenous Fistula
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《新英格兰医药杂志》
A 35-year-old man presented with high-output congestive heart failure. Fourteen years earlier, he had received a shrapnel wound to the left thigh in a car-bomb attack in Lebanon. As a consequence, a progressively enlarging pulsatile mass had developed in the left side of the groin. Angiography showed a large arteriovenous fistula involving the deep femoral artery and vein (Panel A, arrow). A computed tomographic scan showed a large, thrombosed false aneurysm associated with the fistula (Panel B, arrow); a shrapnel fragment was also present (arrowhead). At surgery, all inflow and outflow vessels associated with the fistula were ligated. After surgery, the mass was no longer pulsatile, and the congestive heart failure resolved promptly.
Oren K. Steinmetz, M.D.
L.P. Palerme, M.D.
McGill University Health Center
Montreal, QC H3A 1A1, Canada
Oren K. Steinmetz, M.D.
L.P. Palerme, M.D.
McGill University Health Center
Montreal, QC H3A 1A1, Canada