Patrick Z. McVeigh, PhD, Ahmed Kayssi, MD, Aaron Lo, MD, Dheeraj K

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Presentation transcript:

Repair of popliteal aneurysm and spontaneous arteriovenous fistula in a patient with Marfan syndrome Patrick Z. McVeigh, PhD, Ahmed Kayssi, MD, Aaron Lo, MD, Dheeraj K. Rajan, MD, George D. Oreopoulos, MD, MSc, Graham Roche- Nagle, MD, MBA Journal of Vascular Surgery Cases and Innovative Techniques Volume 2, Issue 3, Pages 137-140 (September 2016) DOI: 10.1016/j.jvsc.2016.03.010 Copyright © 2016 The Authors Terms and Conditions

Fig 1 A, Volume-rendered reconstruction of computed tomography angiograms of the abdomen, pelvis, and lower extremities shows a hypertrophied superficial femoral artery (arrow) remains enlarged into the proximal popliteal artery where an arteriovenous fistula (AVF) is suspected, given the dilated deep venous system and rapid transit of contrast to the inferior vena cava (arrowhead). B, Localized volume-rendered reconstruction focused on the popliteal artery (arrow) demonstrates a direct AVF to the popliteal vein (arrowhead), with a normally sized distal popliteal artery below the fistula. Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 137-140DOI: (10.1016/j.jvsc.2016.03.010) Copyright © 2016 The Authors Terms and Conditions

Fig 2 Intraoperative image shows (top) the aneurysmal segment of the popliteal artery (arrow) and dilated popliteal vein at the arteriovenous fistula (AVF) site (arrowheads) and (bottom) the repaired segment with arterial interposition vein graft in situ (arrow) and ligated popliteal venous remnant (arrowheads). Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 137-140DOI: (10.1016/j.jvsc.2016.03.010) Copyright © 2016 The Authors Terms and Conditions

Fig 3 A follow-up magnetic resonance angiography at 6 months demonstrates no residual popliteal aneurysm and no early venous filling of the popliteal or femoral veins. The right iliac and femoral arteries are ectatic. Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 137-140DOI: (10.1016/j.jvsc.2016.03.010) Copyright © 2016 The Authors Terms and Conditions