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October 1978

Management of Major Arteriovenous Fistulas by Arteriographic Techniques

Author Affiliations

From the Departments of Surgery (Drs Yellin and Ricketts) and Radiology (Dr Finck), University of Southern California School of Medicine and the Los Angeles County-University of Southern California Medical Center, Los Angeles.

Arch Surg. 1978;113(10):1153-1159. doi:10.1001/archsurg.1978.01370220039007

• Five patients with major symptomatic arteriovenous fistulas were treated between July 1976 and December 1977. In two patients the fistulas were due to trauma; in two others, malignant neoplasms; and in one patient, congenital angiodysplasia. The anatomic location or extent of each arteriovenous fistula would have made direct surgical access to the fistula sites difficult; therefore, it was elected to use arteriographic embolization techniques to attempt definitive obliteration of the fistulas. Wool-tufted wire coil emboli were used in three patients and gelatin sponge-autologous blood clot was used in two patients. These were precisely embolized to the fistula site by superselective catheterization of the feeding artery. Complete obliteration of the fistulas was achieved in each case with no morbidity. Follow-up clinical and arteriographic examination confirmed persistence of fistula closure.

(Arch Surg 113:1153-1159, 1978)