{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T04:20:00Z","timestamp":1750911600606,"version":"3.37.3"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CVIR Endovasc"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Arteriovenous fistulas involving the anterior abdominal wall can result from trauma. Such fistulas may remain asymptomatic and undetected for a prolonged duration of time. They tend to recruit multiple arterial feeders with remodelling in the feeding arteries, making them challenging to treat.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We discuss a rare case of a 60-year-old male who presented with complaints of a progressive painless swelling in right lower abdomen. There was a history of blunt injury to abdomen at the same site during alleged road traffic accident 3 years ago. On CT angiography, an arteriovenous fistula was localised to the anterior abdominal wall arising predominantly from the right inferior epigastric artery with a giant venous sac and terminating as a tortuous single venous channel into the right external iliac vein. Few other small feeders were also seen arising from branches of right superior epigastric artery along Winslow\u2019s pathway. The main challenge in endovascular management of this patient was embolization of a high flow shunt with a large venous sac and multiple arterial feeders. The dominant arterial feeder was embolized using vascular plug. The superficial location of the lesion offered an additional percutaneous window besides endovascular approach. The venous sac was percutaneously accessed and embolized using n-butyl cyanoacrylate after balloon occlusion of outflow vein. On follow up ultrasonographic evaluation at 3 months, near complete thrombosis of the venous sac was achieved.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Traumatic arteriovenous fistulas involving the inferior epigastric vessels are rare clinical entities. CT angiogram and digital subtraction angiography help in the optimal diagnosis and treatment planning. The use of mechanical embolization devices to cause flow arrest offers an opportunity to use liquid embolic agents which offer better percolation within the lesion. Interventional radiology offers an ideal management of these complex high flow fistulas with a good technical success and acceptable safety profile.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s42155-024-00455-5","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T12:01:29Z","timestamp":1714996889000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Endovascular and percutaneous embolization of a giant post traumatic arteriovenous fistula of inferior epigastric vessels"],"prefix":"10.1186","volume":"7","author":[{"given":"Venkata Subbaih","family":"Arunachalam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3699-0272","authenticated-orcid":false,"given":"Smily","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jineesh","family":"Valakkada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anoop","family":"Ayyappan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayakrishnan","family":"Radhakrishnan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santhosh Kumar","family":"Kannath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"issue":"4","key":"455_CR1","doi-asserted-by":"publisher","first-page":"e234220","DOI":"10.1136\/bcr-2019-234220","volume":"13","author":"SRDO Raymundo","year":"2020","unstructured":"Raymundo SRDO, Leite RLT, Reis LF, Russeff GJDS. Traumatic arteriovenous fistula with serious haemodynamic repercussions: endovascular treatment. BMJ Case Rep. 2020;13(4):e234220. https:\/\/doi.org\/10.1136\/bcr-2019-234220.","journal-title":"BMJ Case Rep"},{"issue":"9","key":"455_CR2","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1002\/bjs.1800810912","volume":"81","author":"JV Robbs","year":"1994","unstructured":"Robbs JV, Carrim AA, Kadwa AM, Mars M. Traumatic arteriovenous fistula: experience with 202 patients. Br J Surg. 1994;81(9):1296\u20139. https:\/\/doi.org\/10.1002\/bjs.1800810912.","journal-title":"Br J Surg"},{"issue":"6","key":"455_CR3","doi-asserted-by":"publisher","first-page":"W547","DOI":"10.2214\/AJR.05.0777","volume":"188","author":"N Beck-Razi","year":"2007","unstructured":"Beck-Razi N, Soudack M, Gaitini DE. Acquired arteriovenous fistula at an unusual site. AJR Am J Roentgenol. 2007;188(6):W547\u2013549. https:\/\/doi.org\/10.2214\/AJR.05.0777.","journal-title":"AJR Am J Roentgenol"},{"issue":"902","key":"455_CR4","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1259\/bjr\/87038703","volume":"76","author":"A Pi\u00f1ero","year":"2003","unstructured":"Pi\u00f1ero A, Reus M, Agea B, Capel A, Riquelme J, Parrilla P. Case report: conservative management of an arteriovenous fistula of the inferior epigastric artery. Br J Radiol. 2003;76(902):135\u20136. https:\/\/doi.org\/10.1259\/bjr\/87038703.","journal-title":"Br J Radiol"},{"issue":"4","key":"455_CR5","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s100169900067","volume":"11","author":"D Melli\u00e8re","year":"1997","unstructured":"Melli\u00e8re D, Hassen-Khodja R, Cormier JM, Le Bas P, Mikati A, Ronsse H. Proximal arterial dilatation developing after surgical closure of long-standing posttraumatic arteriovenous fistula. Ann Vasc Surg. 1997;11(4):391\u20136. https:\/\/doi.org\/10.1007\/s100169900067.","journal-title":"Ann Vasc Surg"},{"issue":"5","key":"455_CR6","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1016\/j.jvs.2009.11.080","volume":"51","author":"M Chaudry","year":"2010","unstructured":"Chaudry M, Flinn WR, Kim K, Neschis DG. Traumatic arteriovenous fistula 52 years after injury. J Vasc Surg. 2010;51(5):1265\u20137. https:\/\/doi.org\/10.1016\/j.jvs.2009.11.080.","journal-title":"J Vasc Surg"},{"issue":"3","key":"455_CR7","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1016\/j.jvs.2020.08.138","volume":"73","author":"FA Wenzl","year":"2021","unstructured":"Wenzl FA, Miljkovic SS, Dabestani PJ, Kessler JJ II, Kotaru TR, Kalamchi LD, et al. A systematic review and individual patient data meta-analysis of heart failure as a rare complication of traumatic arteriovenous fistulas. J Vasc Surg. 2021;73(3):1087\u201394. https:\/\/doi.org\/10.1016\/j.jvs.2020.08.138.","journal-title":"J Vasc Surg"},{"issue":"1","key":"455_CR8","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.diii.2013.09.004","volume":"95","author":"N Brucher","year":"2014","unstructured":"Brucher N, Moskovitch G, Otal P, Chaufour X, Rousseau H. Inferior mesenteric arteriovenous fistula treated by percutaneous arterial embolization: a breathtaking story! Diagn Interv Imaging. 2014;95(1):85\u20136. https:\/\/doi.org\/10.1016\/j.diii.2013.09.004.","journal-title":"Diagn Interv Imaging"},{"issue":"4","key":"455_CR9","doi-asserted-by":"publisher","first-page":"55","DOI":"10.17691\/stm2020.12.4.07","volume":"12","author":"KR Dzhagraev","year":"2020","unstructured":"Dzhagraev KR, Muslimov RS, Klimov AB, Ryabukhin VE, Kim TE, Selina IE, et al. Endovascular occlusion of giant posttraumatic pseudo-aneurysm of superior mesenteric artery connected to mesenteric arteriovenous fistula. Sovrem Tehnologii Med. 2020;12(4):55\u201361. https:\/\/doi.org\/10.17691\/stm2020.12.4.07.","journal-title":"Sovrem Tehnologii Med"}],"container-title":["CVIR Endovascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-024-00455-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42155-024-00455-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-024-00455-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T12:01:32Z","timestamp":1714996892000},"score":1,"resource":{"primary":{"URL":"https:\/\/CVIRendovasc.springeropen.com\/articles\/10.1186\/s42155-024-00455-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,6]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["455"],"URL":"https:\/\/doi.org\/10.1186\/s42155-024-00455-5","relation":{},"ISSN":["2520-8934"],"issn-type":[{"type":"electronic","value":"2520-8934"}],"subject":[],"published":{"date-parts":[[2024,5,6]]},"assertion":[{"value":"13 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"43"}}