A.V.-Fistel nach Implantation eines femoropoplitealen Bypasses

The following report concerns a 52-year-old patient suffering from coronary disease, who underwent coronary surgery in a department of heart- and vascular surgery. The implantation of a femoropopliteal bypass with anastomosis in the first popliteal segment was done during the same operation due to a long-distance occlusion of the superficial femoral artery on the right side. Some months later the patient consulted us, complaining of severe pain in his right leg and an immensly reduced walking distance. The arteriography showed an arteriovenous fistula of the right leg after implantation of a femoropopliteal bypass. The cause for this was an anastomosis of the distal part of the bypass with the popliteal vein. The patient underwent surgery again with ligature of the distal part of the bypass and reanastomosis with the original popliteal artery in the first segment. The arteriography done during the operation then showed correct conditions. Afterwards the distance the patient could walk was prolonged and he was without pain.