Congenital arteriovenous fistulas (AVFs) of the popliteal artery represent an exceptionally rare subset of peripheral vascular pathology. This report highlights the diagnosis, imaging workup, and endovascular management of a nontraumatic, idiopathic popliteal AVF in a patient with unremarkable medical history who presented with 18 months of left leg pain and swelling. Duplex imaging revealed a large, high-flow left popliteal AVF that was successfully excluded using overlapping stent grafts.
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