Abstract
Background
. Mine blast wounds in modern armed conflicts are characterized by a high frequency of damage to major vessels, which in the long term can lead to the formation of false aneurysms and arteriovenous fistulas. Such complications often cause chronic venous hypertension, trophic disorders, and life-threatening bleeding, requiring timely, high-tech surgical correction.
Case Study
. A 29-year-old patient with a blind shrapnel wound to the left leg is presented. Two years after the injury, the clinical picture of a posttraumatic arteriovenous fistula developed: edema, systolic thrill along the vascular bundle, and a non-healing trophic ulcer with recurrent profuse bleeding. A comprehensive imaging study (angiography) confirmed the presence of an arteriovenous shunt at the level of the posterior tibial artery. Endovascular closure of the fistula was urgently performed with two BIOTRONIK PK Papirus stent grafts. The postoperative period was uneventful, bleeding was controlled, and pulsation of the main arteries was preserved. The patient was discharged on the 3 day with recommendations for antiplatelet therapy and follow-up.
Conclusion
. Endovascular closure of post-traumatic arteriovenous fistulas with stent grafts is a safe and effective method of choice in patients with delayed complications of gunshot wounds to the extremities, avoiding traumatic open surgery and achieving rapid clinical success.