RT Book, Section A1 Akingba, A. George A1 Lemmon, Gary W. A2 Dean, Steven M. A2 Satiani, Bhagwan A2 Abraham, William T. SR Print(0) ID 1105289410 T1 LOWER EXTREMITY: ARTERIOVENOUS FISTULA T2 Color Atlas and Synopsis of Vascular Diseases YR 2015 FD 2015 PB McGraw-Hill Medical PP New York, NY SN 9780071749541 LK accesssurgery.mhmedical.com/content.aspx?aid=1105289410 RD 2024/03/28 AB A 58-year-old healthy man initially presented to the emergency room with gunshot wound (GSW) birdshot injuries to the back of his left leg that occurred on a hunting trip. His initial examination showed normal pulses without any localized neurologic deficits. He was reevaluated in the clinic 1 month later with a thrill in the popliteal fossa and diminished pedal pulses. A duplex ultrasound study confirmed an arteriovenous fistula (AVF) at the level of the proximal posterior tibial artery (PTA) or distal popliteal artery. An endovascular intervention resulted in successful coverage of the AVF and improvement of distal limb perfusion (Figure 1).