Presenter: Emre Gurel

Affiliation: Marmara University School of Medicine, Turkey

Abstract

This article describes a 53-year-old male with posttraumatic pedal arteriovenous fistulas (AVFs) treated by Amplatzer plugs and a novel “closed-loop balloon-stent” technique. Post-procedural thrill resolution and bleeding cessation confirmed the efficacy of this minimally invasive approach.

Introduction

Complex AVFs pose surgical challenges due to anatomical intricacy. This case highlights percutaneous innovations for fistula closure.

Case Study

The patient presented with right foot thrill and intermittent bleeding after trauma.

Imaging revealed multiple plantar arch AVFs.

Intervention:

Primary Closure: Amplatzer Vascular Plug 4 devices (6×11mm, 8×13.5mm) occluded dominant fistulas.

Secondary Technique: Residual collaterals were sealed using a closed-loop balloon-stent system (modified angioplasty balloon combined with coronary stent).

Follow-up showed resolved symptoms and improved ankle swelling.

Conclusions

1.Amplatzer plugs effectively occlude major fistulas.

2.The closed-loop technique targets microchannels with precision.

3.Staged therapy optimizes outcomes in complex AVFs.