What is a treatment option for an iatrogenic AV fistula?

• A. Doppler-guided compression
• B. Implantation of a covered stent
• C. Surgical repair
• D. All of the above

Answer: (D)

Treatment options for an iatrogenic AV fistula include Doppler-guided compression, a covered stent, and surgical repair, with the best choice depending on the fistula’s size, flow, symptoms, and anatomy. Small, low-flow fistulas may close with ultrasound-guided compression, which encourages thrombosis of the abnormal connection. For larger or high-flow fistulas, an endovascular approach with a covered stent can exclude the fistula by sealing the arterial entry, while preserving normal arterial blood flow. If the fistula is not amenable to endovascular treatment or if complications arise, surgical repair to directly close or reconstruct the involved vessels is a definitive option. Thus, all of these approaches are valid treatment options in different clinical scenarios.