Tratamento de fístula arteriovenosa adquirida com repercussões hemodinâmicas graves: desafio terapêutico Treatment of acquired arteriovenous fistula with severe hemodynamic effects: therapeutic challenge

Abstract A 34-year-old female patient with severe heart failure and pulmonary hypertension was diagnosed late with a high-output acquired arteriovenous fistula between the right common iliac vein and artery. The most probable cause was an iatrogenic vascular injury inflicted during a prior laparoscopic cholecystectomy. Treatment was conducted by placement of an endoprosthesis in the common iliac artery, achieving total exclusion of the fistula and complete remission of symptoms. Considering the options available for treating this type of lesion, endovascular techniques are becoming ever more effective and are now the option of first-choice for management of this pathology.Keywords: arteriovenous fistula; endoprothesis; heart failure. 1 Universidade Estadual de Campinas – UNICAMP, Faculdade de Ciencias Medicas, Campinas, SP, Brasil. Fonte de financiamento: Nenhuma.Conflito de interesse: Os autores declararam nao haver conflitos de interesse que precisam ser informados.Submetido em: 18.01.13. Aceito em: 10.10.13.O estudo foi realizado para Conclusao de Curso de Residencia Medica em Cirurgia Vascular no Servico de Cirurgia Vascular do Hospital de Clinicas da Universidade Estadual de Campinas (UNICAMP) - Disciplina de Molestias Vasculares, Faculdade de Ciencias Medicas – UNICAMP.