ARTERIOVENOUS-FISTULA AFTER ENDOSCOPIC DI SSECTION OF PERFORATING VEINS OF THE CALF IN A PATIENT WITH CHRONIC VENOUS DISTENSION USING THE NEODYM-YAG-LASER

The endoscopic dissection of the perforating veins has been invented b y Hauer in the last decade. He introduced the videoendoscopy to this s urgical procedure. The avoidance of operative access through areas of trophic changes is very benefical for reducing postoperative complicat ions, Although postoperative thermic lesion have been reported an. Fol lowing an endoscopic laser coagulation of a Cockett perforating vein a n arterio-venous fistula between the posterior tibial artery and vein developed by the mechanism mentioned. Persisting pain and the persista nce of the ulcer led to several diagnostic measures including phlebogr aphy, digital substraction angiography and CT-scan. After the fistula had been closed successfully by percutaneous embolization with four pl atin wires the ulcer disappeard.