ABSTRACT
A 64-year old woman presented for endovascular repair of an arteriovenous (AV) fistula of the subclavian artery and vein. Her left ventricular function was normal and her coronary arteries were within normal limits. She received an implantable defibrillator for a sudden death episode. The following year the leads were revised using the excimer laser as a result of multiple twists in the electrodes. After that procedure, she complained of fatigue and dyspnea. A continuous murmur was heard over the left subclavian region. Arteriography of the left subclavian artery revealed an AV fistula (Figure 17.1). After obtaining approval for compassionate use from our Institutional Review Board and the Food and Drugs Agency (FDA), the patient underwent a procedure to exclude the AV fistula with a covered stent.
