case_images: PMC7273581_01
case_images: Abnormal arterial flow to the recanalized segment of previously ablated great saphenous vein (GSV) from the right superficial femoral artery (SFA) (a). Under the guidance of arteriography, endovenous laser ablation (EVLA) for two anterior accessory saphenous veins (AASV) was performed (red arrows). Black arrow indicates where ablation of the great saphenous vein (GSV) was previously performed. Green arrow indicates the recanalized segment of previously ablated GSV (b). A final angiogram showed reduced abnormal flow and no inflow to AASVs from SFA (c).
case_images: 10.1177_2050313X20926423-fig1.jpg
case_images: PMC7273581_01_10.1177_2050313X20926423-fig1.jpg
case_images: fig1-2050313X20926423
case_images: Duplex ultrasound suspected abnormal arterial flow from the right superficial femoral artery (SFA) to the recanalized segment of previously ablated GSV and anterior accessory saphenous vein (AASV) (Figure 1(a)). AASV using arteriographic guidance (Figure 1(b)). A final angiogram showed reduced abnormal flow and no inflow to AASVs from SFA (Figure 1(c)).
case_images: Computed tomography angiography shows the location of superficial recurrent varicose veins, the superficial femoral artery (SFA) and the arteriovenous connection. White arrow indicates two of the detective fistulous connections from SFA to anterior accessory saphenous vein (AASV).
case_images: 10.1177_2050313X20926423-fig2.jpg
case_images: PMC7273581_01_10.1177_2050313X20926423-fig2.jpg
case_images: fig2-2050313X20926423
case_images: Computed tomography angiography confirmed the same findings (Figure 2). Figure 8-18 Fibered Platinum Coils 2 mm x 5 mm + 1 VortXTM Diamond-18 Fibered Platinum Coils 3 mm x 3.3 mm + 1 Straight-18 Fibered Platinum Coils 5 mm for the proximal fistula, 2 Figure 8-18 2 mm x 5 mm for the middle fistula, and 1 Figure 8-18 2 mm x 5 mm + 2 VortXTM Diamond-18 3 mm x 3.3 mm + 1 Straight-18 5 mm for the distal fistula, Boston Scientific, Marlborough, MA) were implanted to the visible three fistulas (Figure 3(a)). Final arteriography from SFA showed no abnormal fistulous flow to the veins (Figure 3(b)) and the patient was still free of symptoms.
case_images: A total of 10 coils were implanted to the visible three fistulas (a). Final arteriography from superficial femoral artery (SFA) showed no abnormal fistulous flow to the veins (b).
case_images: 10.1177_2050313X20926423-fig3.jpg
case_images: PMC7273581_01_10.1177_2050313X20926423-fig3.jpg
case_images: fig3-2050313X20926423
case_images: Figure 8-18 Fibered Platinum Coils 2 mm x 5 mm + 1 VortXTM Diamond-18 Fibered Platinum Coils 3 mm x 3.3 mm + 1 Straight-18 Fibered Platinum Coils 5 mm for the proximal fistula, 2 Figure 8-18 2 mm x 5 mm for the middle fistula, and 1 Figure 8-18 2 mm x 5 mm + 2 VortXTM Diamond-18 3 mm x 3.3 mm + 1 Straight-18 5 mm for the distal fistula, Boston Scientific, Marlborough, MA) were implanted to the visible three fistulas (Figure 3(a)). Final arteriography from SFA showed no abnormal fistulous flow to the veins (Figure 3(b)) and the patient was still free of symptoms.