Endovascular Management of a Post-traumatic Popliteal Fossa Arteriovenous Fistula

Abstract

Background: Arteriovenous fistulas (AVFs) are abnormal communications between an artery and a vein. Posttraumatic AVFs, including those in the popliteal fossa, are rare but require prompt management to prevent complications.
Case Report: A 35-year-old male presented with a painful, pulsatile swelling over the left knee, 15 days postarthroscopic anterior cruciate ligament and posterior cruciate ligament reconstruction. Clinical examination showed a 5 × 5 cm² tender swelling with a palpable thrill. Computed tomography angiography revealed a communication between the popliteal artery and vein. An endovascular intervention was performed using two Bentley covered balloon expandable stents. Post-procedure, the patient showed uneventful recovery, with follow-up Doppler scans indicating normal vascular flow and no residual abnormalities.
Conclusions: Post-traumatic AVFs, often resulting from penetrating injuries or iatrogenic causes, can present with painful, pulsatile swellings and may lead to severe complications if untreated. Advances in endovascular techniques, such as stenting, have improved outcomes such as reduced post-operative morbidity, eliminating complications associated with open surgery.