JOURNAL ARTICLE

Venous ulcer: late complication of a traumatic arteriovenous fistula

Calvin J Young, Alan Dardik, Bauer Sumpio, Jeff Indes, Bart Muhs, Cassius I Ochoa Chaar
Annals of Vascular Surgery 2015, 29 (4): 836.e1-3
25725283
Arteriovenous fistula (AVF) formation after penetrating trauma is a well-described phenomenon. However, diagnosis of traumatic AVF is frequently delayed as patients often do not have hard signs of vascular injury at the initial presentation. Late complications of traumatic AVF include arterial and venous dilatation, distal ischemia, venous congestion, and congestive heart failure. This case report describes a traumatic femoral AVF causing distal venous ulceration 3 years after the injury. The AVF was treated with open repair. In the operating room, the Nicoladoni-Branham sign was elicited. The ulcer healed at 1 month and has not recurred at 1-year follow-up.

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