Abstract
Pseudoaneurysm with arteriovenous fistula is a rare presentation of penetrating trauma, occurs when trauma involves major blood vessels, and is traditionally treated surgically. Recently, these are more commonly treated using endovascular techniques which include stent graft placement and parent artery occlusion. In this case report, we present a case of femoral artery pseudoaneurysm and arteriovenous fistula with severe size difference between the arterial segments proximal and distal to the fistula site, treated successfully by using the upside-down gore excluder limb technique.