POSTLAMINECTOMY ARTERIOVENOUS-FISTULA MASKED BY STENOSIS OF THE INFERIOR VENA-CAVA

Discovery of a postlumbosacral discectomy fistula between the right il iac artery and vein was obscured by an associated severe stricture of the infrarenal inferior vena cava in a 49-year-old man. During venous stenting for treatment of peripheral edema, the fistula was suspected because of faint pulsatile right iliac vein flow and increased O2 satu ration of the venous blood. The suspicion was confirmed on subsequent iliac arteriography. Surgical closure of the fistula with arterial int erposition grafting was then performed. The patient improved substanti ally.