Peroneal Arteriovenous Fistula and Pseudoaneurysm
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Introduction
Arteriovenous fistulas often result from iatrogenic trauma while gaining percutaneous vascular access. Turbulent blood flow and endothelial damage may eventually lead to pseudoaneurysm formation with resulting mass effect and risk of massive hemorrhage. While several case reports have documented peroneal pseudoaneurysms resulting from iatrogenic and orthopedic trauma, there are no known reports of both an arteriovenous fistula and pseudoaneurysm presenting in a patient with an undiagnosed connective tissue disorder. Utilizing multiple imaging modalities, this case nicely documents the unique vascular findings in this interesting case.

Case Report
A healthy 14-year-old male presented with acute onset lower extremity calf pain and swelling that began while playing soccer. He denied trauma to the limb and on physical exam was neurovascularly intact. An MRI to evaluate possible ligamentous injury revealed a large abnormal flow void adjacent to the peroneal artery and vein thought to represent a pseudoaneurysm or arteriovenous malformation. CT angiogram of the lower leg showed a direct communication between the peroneal artery and vein with early filling of the peroneal and popliteal veins indicating an arteriovenous fistula. There was also a focal dilatation at the communication of the vessels compatible with a pseudoaneurysm. These findings were redemonstrated on contrast enhanced MR angiogram......

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199079/
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