Coil embolization of iatrogenic arterio-venous fistula from pulmonary collateral artery to subclavian vein

A young woman with surgically treated tetralogy of Fallot with pulmonary atresia, with multiple aorto-pulmonary collateral arteries, developed an arteriovenous fistula subsequent to transvenous insertion of an automatic implantable defibrillator via the left subclavian vein. The fistula extended between this vein and a systemic-to-pulmonary collateral artery arising from the subclavian artery. Unilateral peau d'orange, and painful congestion of the left arm and breast, ensued. These were cured by coil embolization of a fistula-related aneurysm