case_images: PMC10864154_01
case_images: Ilio-iliac arteriovenous fistula with May-Thurner syndrome in an 80-year-old male.. A. CT angiography MIP image reveals early draining of the left iliac and femoral veins, with extensive AVFs arising from the left internal iliac artery.. B. Left internal iliac artery angiogram. A few seconds after contrast administration, early draining of the left internal iliac vein (arrow) and left external iliac vein (arrowhead) is observed, indicating an ilio-iliac AVF.. C. Collateral vessels arising from the left circumflex iliac artery supplying the incompletely packed main trunk (arrow) of the left internal iliac artery are observed.. D. Left inferior epigastric artery angiogram. An angiogram showing multiple AVFs (arrow) originating from the left inferior epigastric artery.. E. Pre-embolization CT scan (left) and post embolization CT scan (right, two months later). Note improvement of left leg edema on post embolization CT scan.. AVF = arteriovenous fistula, MIP = maximum intensity projection
case_images: jksr-85-235-g001.jpg
case_images: PMC10864154_01_jksr-85-235-g001.jpg
case_images: F1
case_images: CT angiography. CT angiography confirmed the diagnosis of ilio-iliac AVF, with findings of early draining in the left iliac and femoral veins with extensive collaterals (Fig. 1A). Angiography revealed numerous AVFs arising from the left internal iliac artery (Fig. 1B). After embolization of the main trunk of the left internal iliac artery, angiography revealed collateral vessels arising from the left circumflex iliac artery supplying the incompletely packed main trunk of the left internal iliac artery (Fig. 1C). Multiple AVFs originating from the left inferior epigastric artery were observed on a left inferior epigastric artery angiogram (Fig. 1D). In addition, improvement in the left leg edema was evident on a follow-up abdominopelvic CT scan after two months (Fig. 1E).