Repair of a large iliac vein aneurysm secondary to a high-flow pelvic arteriovenous malformation under deep hypothermic circulatory arrest.

A 15-year-old boy presented first in 2012 with chronic abdominal pain and high-output congestive heart failure (CHF) due to a left iliac vein aneurysm secondary to high-flow pelvic arteriovenous malformation (AVM). Despite several embolization interventions with coils and Onyx (ev3, Covidien, Plymouth, Minn), the patient continued to have episodes of CHF. Magnetic resonance imaging (MRI) demonstrated a left iliac vein aneurysm with a diameter of 13 cm (A, left). To reduce flow from the AVM, an endograft from the inferior vena cava to the left external iliac vein was deployed, successfully treating his CHF.