Endovascular Treatment of Ruptured Abdominal Aortic Aneurysm with Aortocaval Fistula

Journal Article · Sun Aug 15 00:00:00 EDT 2010 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9640-5· OSTI ID:21428972

Guzzardi, Giuseppe; Fossaceca, Rita; Divenuto, Ignazio ^[1]; Musiani, Antonello; Brustia, Piero ^[2]; Carriero, Alessandro ^[1]

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1. Maggiore della Carita Hospital, Institute of Interventional Radiology (Italy)
2. Maggiore della Carita Hospital, Division of Vascular Surgery (Italy)

Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA). We report the endovascular repair of an AAA rupture into the inferior vena cava. A 78-year-old woman was admitted to our hospital for acute hypotension. She presented with a pulsatile abdominal mass and became rapidly anuric. Abdominal computed tomography (CT) showed an AAA rupture into the inferior vena cava. The features of the AAA made it suitable for endovascular repair. To prevent pulmonary embolism caused by the presence of sac thrombosis near the vena cava lumen, a temporary vena cava filter was deployed before the procedure. A bifurcated stent-graft was placed with the patient under local anaesthesia, and the AAA was successfully treated. A transient type II endoleak was detected on CT 3 days after endograft placement. At routine follow-up 6 and 12 months after the procedure, the patient was in good clinical condition, and the type II endoleak had sealed completely. Endovascular treatment offers an attractive therapeutic alternative to open repair in case of ACF; however, only small numbers of patients have been treated, and long-term follow-up interval is lacking.

• OSTI ID: 21428972
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 33, Issue 4; Other Information: DOI: 10.1007/s00270-009-9640-5; Copyright (c) 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABDOMEN
AORTA
COMPUTERIZED TOMOGRAPHY
FILTERS
FISTULAE
GRAFTS
HYPOTENSION
REPAIR
RUPTURES
TUBES
VEINS
ARTERIES
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
DIAGNOSTIC TECHNIQUES
FAILURES
ORGANS
PATHOLOGICAL CHANGES
TOMOGRAPHY
TRANSPLANTS