A 45-year-old woman undergoes cardiac catheterization through a right femoral approach. Two months later, she complains of right lower extremity swelling and notes the appearance of multiple varicosities. On examination, a bruit is heard over the right groin. What is the most likely diagnosis?

A traumatic AV fistula results from a penetrating injury to adjacent artery and vein, permitting blood flow from the injured artery into the vein. The iatrogenic injury in this case occurred during cardiac catheterization. Femoral artery thrombosis results in signs of limb ischemia. A bruit is usually not heard with venous insufficiency. Traumatic pseudoaneurysm presents as an enlarging pulsating mass. Once the diagnosis of AV fistula is made, an angiogram is performed, and surgical repair (division of the fistula and reconstruction of the artery and preferably of the injured vein as well) is carried out.