A 49-year-old man underwent catheter ablation for drug-refractory atrial fibrillation using right femoral access. A 3-French sheath was placed in the right CFA, and an 8-French sheath was placed in the right FV during the catheterization. After the procedure, he developed swelling around the puncture site, and a bruit was audible in the right groin on auscultation. An AVF was detected by color Doppler ultrasound (Figure ). Ultrasound-guided compression was attempted but was unsuccessful. Enhanced computed tomography (CT) showed an MCFA originating from the CFA that crossed anterior to the FV and an arteriovenous communication (Figure ).\nExpecting spontaneous resolution, the patient was initially treated conservatively. After six months of follow-up, the AVF did not disappear on ultrasonography, and he suffered recurrence of atrial fibrillation. Considering the risk of future cardiac complications due to sustained volume overload, surgical intervention was performed. Surgical exploration revealed a dilated MCFA that crossed anterior to the FV (Figure ).\nThe MCFA was attached to the FV, and thrill was present. Ligation of the AVF was performed. A completion angiogram demonstrated successful closure of the AVF (Figure ).\nThe postoperative course was uneventful, and the patient was discharged on postoperative day 4.
A 55-year-old male with left BCF, had VH with extensive edema of upper limb Upper limb DSA revealed left subclavian stenosis. BD with EVS was done and AVF was preserved, and limb edema disappeared in 72 h [].