Pelvic arteriovenous fistulas: therapeutic strategy in five cases.

Pelvic arteriovenous fistulas are rare. They may be defined as arteriovenous communications developing in the pelvis from the internal iliac artery, the origin of its posterior trunk or branches of its anterior trunk. Congenital arteriovenous malformations, more common in women, and posttraumatic arteriovenous fistulas are the two main etiological forms. Diagnostic problems include appreciation of visceral extension in arteriovenous malformations and precise localization of fistulas especially when they affect the internal iliac artery itself. Therapy is aimed at complete closure of arteriovenous communications using interventional radiologic methods or surgery. Although indications are difficult to assess, complete, one-stage therapy is preferable due to surgical difficulties following failed or incomplete radiological or surgical attempts.