Spontaneous inferior mesenteric arteriovenous fistula as a cause of severe portal hypertension and cardiomyopathy Jaideep Das Gupta, MD, Muhammad A.

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Spontaneous inferior mesenteric arteriovenous fistula as a cause of severe portal hypertension and cardiomyopathy Jaideep Das Gupta, MD, Muhammad A. Rana, MD, Adam Delu, MD, Sundeep Guliani, MD, Mark Langsfeld, MD, John Marek, MD Journal of Vascular Surgery Cases and Innovative Techniques Volume 5, Issue 2, Pages 113-116 (June 2019) DOI: 10.1016/j.jvscit.2018.11.007 Copyright © 2018 The Authors Terms and Conditions

Fig 1 Computed tomography (CT) angiography demonstrates the inferior mesenteric artery (IMA) with irregular filling of the inferior mesenteric vein (IMV; arrows). A, Axial view. B, Coronal view. C, Three-dimensional reconstruction. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 113-116DOI: (10.1016/j.jvscit.2018.11.007) Copyright © 2018 The Authors Terms and Conditions

Fig 2 A, Selective arteriogram of the arteriovenous fistula (AVF) originating off the distal inferior mesenteric artery (IMA). B, Completion coil embolization arteriogram of the distal sigmoidal branches of the IMA, higher origin of superior rectal artery, and main trunk of IMA proximal to the fistula (arrows). C, Arteriogram shows previous embolization sites of the IMA with increased proximal neovascularization (arrow). D, Arteriogram after placement of proximal Amplatzer plugs (arrow). E, Post-venous embolization (arrow) IMA arteriogram showed complete cessation of flow across the arteriovenous malformation (AVM) into the inferior mesenteric vein (IMV). Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 113-116DOI: (10.1016/j.jvscit.2018.11.007) Copyright © 2018 The Authors Terms and Conditions

Fig 3 A, Computed tomography (CT) angiography shows no contrast material within the embolized inferior mesenteric vein (IMV) or downstream from the embolized inferior mesenteric artery (IMA). B, Three-dimensional reconstruction of segmental embolization of IMA and IMV. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 113-116DOI: (10.1016/j.jvscit.2018.11.007) Copyright © 2018 The Authors Terms and Conditions