In Reply to: Re: Case 0400_10 -- Recurrent Pseudoaneurysm and Arteriovenous Fistula Following Embolization posted by Eric Walser on April 18, 2000 at 07:43:38:
I once showed a case to Dr. Keller of a 21-year-old man with a 12-year history of AV fistula in his thigh (http://scvir.org/members/caseclub/0898/0898_06/0898_06.htm). I thought that treating the arterial side with a stent-graft would resolve the problem. It did resolve the problem for a week and then the lesion recruited many other vessels to feed it. The only time that it resolved was by going into the venous side and embolizing with coils the AV communication (nidus). Then the lesion resolved without ever coming back. Unfortunately I had to deal with intimal hyperplasia in the stent-graft later.
Dr. Keller showed a number of similar cases where occlusion of the AV communication rather than the arterial feeders resulted in a cure.
I think that this is an important point as we somehow intuitively go for the arterial feeders first.