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-What’s an A-V fistula and what’s the standard practice for correcting one? It was found in the right groin 2 weeks after an angioplasty was performed. -
A fistula is an abnormal connection between two adjacent structures or organs within the body, or from within the body to the outside. An A-V (arteriovenous) fistula refers to a connection between an artery and a vein. A-V fistulas may be congenital (present at birth), spontaneous, or the result of trauma.
In the groin, the femoral artery and vein are located right next to each other. Occasionally, when entering the femoral artery with a needle in order to do an angiogram or angioplasty, the vein also may be punctured. If this leads to a fistula, blood flows from the high pressure artery to the low pressure vein and then back to the heart. This is often recognized by listening over the artery with a stethoscope. The blood flowing from high pressure to low pressure creates a noise known as a bruit.
An A-V fistula in the groin creates an increased workload for the heart and reduces arterial blood flow to the leg. In addition, the veins of the involved leg may become enlarged and congested. Fistulas tend to enlarge gradually and therefore closure is recommended, usually by a surgical procedure.