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A 35-year-old man presented with high-output congestive heart failure. Fourteen years earlier, he had received a shrapnel wound to the left thigh in a car-bomb attack in Lebanon. As a consequence, a progressively enlarging pulsatile mass had developed in the left side of the groin. Angiography showed a large arteriovenous fistula involving the deep femoral artery and vein (Panel A, arrow). A computed tomographic scan showed a large, thrombosed false aneurysm associated with the fistula (Panel B, arrow); a shrapnel fragment was also present (arrowhead). At surgery, all inflow and outflow vessels associated with the fistula were ligated. After surgery, . . . [Full Text of this Article] |
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