title: Endovascular repair of an aorto-left renal vein fistula due to a ruptured abdominal aortic aneurysm after EVAR.
abstract: OBJECTIVE
  To report an unusual late complication of endovascular aneurysm repair: an arteriovenous fistula between the aneurysm sac and a retro-aortic left renal vein following sac expansion due to a type III endoleak.
  
  
  METHODS
  A 79-year-old man developed an arteriovenous fistula between the aneurysm sac and a retro-aortic left renal vein 67 months after endovascular aneurysm exclusion (EVAR). Aneurysm rupture was due to disconnection between the right iliac limb and an extender cuff. The problem was repaired percutaneously with another endograft bridging the two prostheses. At 16 months, the aneurysm sac diameter was decreased; there was no evidence of the AV fistula, and the patient was free from any complication related to the EVAR.
  
  
  CONCLUSIONS
  This case emphasizes the need of close surveillance even in the late postoperative course of these patients. Moreover, this rare event confirmed that endovascular techniques can play an important role in treating emergent complications.
authors.affiliation: Unit of Vascular Surgery, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. m.ferrari@ao-pisa.toscana.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Ferrari
authors.forename: Raffaella
authors.initials: R
authors.lastname: Berchiolli
authors.forename: Savino G
authors.initials: SG
authors.lastname: Sardella
authors.forename: Roberto
authors.initials: R
authors.lastname: Cioni
authors.forename: Pasquale
authors.initials: P
authors.lastname: Petruzzi
authors.forename: Andrea
authors.initials: A
authors.lastname: Del Corso
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Mitri
authors.forename: Chiara
authors.initials: C
authors.lastname: Croce
authors.forename: Francesco
authors.initials: F
authors.lastname: Romagnani
authors.forename: Daniele
authors.initials: D
authors.lastname: Adami
authors.forename: Franco
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001012:Aorta, Abdominal; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011475:Prosthesis Failure; D011859:Radiography; D012082:Renal Veins; D012086:Reoperation; D018570:Risk Assessment; D016896:Treatment Outcome