Chronic traumatic AVF leads to significant morbidity when allowed to progress.
Traumatic AVF may be approached with endovascaular, open, and hybrid techniques.
We describe a traumatic AVF which was left to progress for over 30 years.
Our staged, hybrid approach decreased venous hypertension and bleeding during surgery.
Keywords: Endovascular surgery; Hybrid surgery; Traumatic arteriovenous fistula; Vascular surgery.