The Occurrence of Arterio-venous Fistula during Lower Limb Subintimal Angioplasty: Treatment and Outcome.

Objectives: To describe our experience with iatrogenic arterio-venous fistula (AVF) occurring during lower limb subintimal angioplasty, their management and the final clinical, radiological outcome. Design: Retrospective review of case series from two centres, from a computerised database over a period of five years. Material: Twelve patients whose lower limb subintimal angioplasty was complicated by Iatrogenic AVF. Results: The Majority of AVF occurred at the popliteal trifurcation vessels. And the incidence of this complication in our case series was 0.8%. This was managed with a variety of techniques-Coil embolisation, balloon tamponade, alternative dissection and stent placement. In one patient, the fistula was left open intentionally. All twelve patients had a successful angioplasty. The overall technical success rate for AVF ablation was eighty percent. Conclusions: AVF is a potential complication of angioplasty. The majority can be managed by endovascular means during the angioplasty procedure with good technical success. [Copyright &y& Elsevier]