Endovascular Treatment of a Giant Iliac Vein Aneurysm After a Traumatic Arteriovenous Fistula

A 60 year old man with a history of a military mine injury 30 years previously presented with chronic leg swelling and a non-healing ulcer. Computed tomography angiography (CTA) revealed a giant iliac venous aneurysm (Figure A; red arrow) due to a chronic arteriovenous fistula (green arrows) in the proximal superficial femoral artery (SFA; mine fragments indicated by the blue arrows). An iliac limb stent graft (16 – 23 mm × 100 mm; W.L. Gore & Associates, Flagstaff, AZ, USA) was placed via an open antegrade common femoral artery approach into the SFA. The ulcer healed and follow up CTA showed a patent SFA with exclusion of the venous aneurysm (Figure B).