A Spontaneous Arterial Venous Fistula in a Patient on Hemodialysis; Case Report

Abstract

Introduction Arteriovenous fistulas (AVFs) are a form of arteriovenous malformations clinically characterized by anomalous communications between arterial and venous systems that bypass the normal anatomic capillary beds (1). Broadly it can be divided into two forms based on the cause: acquired or congenital. Surgery, penetrating trauma, and percutaneous catheterization are the most common causes of acquired AVFs. Rarely AVFs can be formed in the absence of a clear cause and are called spontaneous AVFs which are rare with very few case reports in the literature (2-4). The anatomy of the fistula depends on the location in the body and where the causative factor was applied. Greater than 50% of traumatic AVFs happen in the lower extremity, and about one-third occur in the femoral vessels, while 15% take place in the popliteal vessels but AVF can occur at any site (5-8).AVFs present clinically with progressively growing pulsatile mass on each respective site associated with or without complications including infection, thrombosis, aneurysm, hypertension, and heart failure demanding timely intervention (9).