{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:24:39Z","timestamp":1763101479672,"version":"3.45.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital arteriovenous fistulas (AVFs) are rare, particularly those involving the bilateral femoral arteriovenous system in an infant. This case report details the successful management of this condition using a combined therapeutic approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a 6-month-old boy who presented with a congenital bilateral femoral arteriovenous fistula, which led to symptoms of fatigue, shortness of breath, and recurrent pneumonia. The patient was successfully treated with a combined therapeutic approach of surgical ligation on the left side and endovascular coil embolization on the right. At the 10-year follow-up, the patient's clinical and echocardiographic status remained normal. The imaging surveillance protocol included regular duplex ultrasound examinations, which confirmed sustained occlusion of both fistulas with no residual dilated veins in the right thigh. The patient remains asymptomatic with no evidence of recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the importance of a tailored, combined-modality approach for complex congenital AVFs, especially when the fistulas on each side possess different anatomical characteristics. The specific morphology of the fistula is a critical determinant in choosing the optimal treatment strategy to ensure complete closure and prevent long-term complications such as high-output cardiac failure. This approach serves as a valuable clinical reference for the management of similar complex vascular anomalies in the pediatric population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1702455","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:22:04Z","timestamp":1763101324000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined surgical and endovascular treatment of congenital bilateral femoral arteriovenous fistulas in a child: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiejun","family":"Xia","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liqi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunshan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianzhong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haibo","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"B1","article-title":"Arteriovenous fistula","volume-title":"Statpearls","author":"Jayroe","year":"2022"},{"key":"B2","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1016\/s0967-2109(98)00080-5","article-title":"Natural history of congenital arteriovenous \ufb01stula","volume":"6","author":"Blaisdell","year":"1998","journal-title":"Cardiovasc Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1212\/WNL.0000000000207327","article-title":"Spinal dorsal intradural arteriovenous fistulas: natural history, imaging, and management","volume":"101","author":"Essibayi","year":"2023","journal-title":"Neurology"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1473685","DOI":"10.3389\/fmed.2024.1473685","article-title":"Extracranial arteriovenous malformations: a 10-year experience at a German vascular anomaly center and evaluation of diagnostic imaging for endovascular therapy assessment","volume":"11","author":"Werba","year":"2024","journal-title":"Front Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"111572","DOI":"10.1016\/j.ejrad.2024.111572","article-title":"Artificial intelligence-based automatic nidus segmentation of cerebral arteriovenous malformation on time-of-flight magnetic resonance angiography","volume":"178","author":"Dong","year":"2024","journal-title":"Eur J Radiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e172837","DOI":"10.1172\/JCI172837","article-title":"Extracranial arteriovenous malformations: towards etiology-based therapeutic management","volume":"135","author":"Coulie","year":"2025","journal-title":"J Clin Invest"},{"key":"B7","doi-asserted-by":"publisher","first-page":"S177","DOI":"10.1097\/SAP.0000000000003375","article-title":"Treatment of challenging extracranial arteriovenous malformations: a single-center experience and literature review","volume":"90","author":"Jia","year":"2023","journal-title":"Ann Plast Surg"},{"key":"B8","first-page":"9","article-title":"Consensus document of the international union of angiology (IUA)-2013. Current concept on the management of arterio-venous management","volume":"32","author":"Lee","year":"2013","journal-title":"Int Angiol"},{"key":"B9","first-page":"612","article-title":"Surgical treatment for a complex congenital arteriovenous malformation of the lower limb","volume":"40","author":"Ozcan","year":"2013","journal-title":"Tex Heart Inst J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"14","DOI":"10.24875\/CIRU.20000802","article-title":"Endovascular management of a complex high-flow lower limb arteriovenous malformation: case report and literature review","volume":"89","author":"Ornelas-Flores","year":"2021","journal-title":"Cir Cir"},{"key":"B11","first-page":"157","article-title":"Percutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures","volume":"47","author":"Waigand","year":"1999","journal-title":"Catheter Cardiovasc Interv"},{"key":"B12","doi-asserted-by":"publisher","first-page":"503","DOI":"10.3892\/etm.2012.832","article-title":"Interventional embolization therapy of puerile congenital deep femoral arteriovenous fistula","volume":"5","author":"Zhang","year":"2013","journal-title":"Exp Ther Med"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1702455\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:22:05Z","timestamp":1763101325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1702455\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,14]]},"references-count":12,"alternative-id":["10.3389\/fped.2025.1702455"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1702455","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,14]]},"article-number":"1702455"}}