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De novo arteriovenous malformations in post-thrombotic limbs
  1. Prajna Bhargavi Kota1,
  2. Albert Abhinay Kota1,
  3. Sunil Agarwal1 and
  4. Shyamkumar N Keshava2
  1. 1Department of Vascular Surgery, Christian Medical College Vellore, Vellore, Tamil Nadu, India
  2. 2Department of Interventional Radiology, Christian Medical College and Hospital Vellore, Vellore, India
  1. Correspondence to Dr Albert Abhinay Kota; albert.cmc{at}


A 50-year-old woman presented with progressive, painful and disabling swelling of the left lower limb following a left ovarian cyst excision 2 years ago. She had gross oedema of the left lower limb with multiple pubic varices. Contrast-enhanced CT and digital subtraction imaging revealed diffuse arteriovenous malformation (AVM) with feeders from the left internal iliac artery and a short segment significant stenosis of the proximal left common iliac vein. She underwent angioplasty and stenting of the left iliac vein. Her symptoms dramatically improved following the procedure and her limb swelling regressed within 6 months. The occurrence of post-thrombotic AVMs has been long established in the dural and portal systems. This report deals with an analogous phenomenon following iatrogenic deep venous thrombosis of the left lower limb, its pathogenesis, natural history and a review of treatment options.

  • vascular surgery
  • interventional radiology
  • general practice / family medicine

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  • Contributors Manuscript writing and revision: PBK and AAK; concept, methodology and editing: AAK, SA and SNK; finalisation: AAK and SNK; overall responsibility: AAK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.