Endovascular treatment of ruptured abdominal aneurysm into the inferior vena cava in patient after stent graft placement.
We report the case of a patient who underwent endovascular repair and then reintervention as a result of the presence of a persistent endoleak complicated by an aortocaval fistula. A 76-year-old patient with a history of endovascular treatment for abdominal aortic aneurysm 2 years earlier had a palpable abdominal mass, high-output cardiac failure, and renal failure. A computed tomographic scan and angiography revealed bending of the right iliac limb, a type I endoleak, and rupture of the aneurysm into the inferior vena cava with aortocaval fistula formation. An iliac extension was positioned in the right external iliac artery. The procedure was finished successfully. Control angiography showed normal flow within the endoprosthesis, and both iliac arteries were without signs of endoleakage and aortocaval fistula. Ectatic common iliac artery may lead to a late distal attachment site endoleak. The application of a stent graft in cases of secondary aortocaval fistula after stent graft repair is a good option, particularly in emergency cases.
Juszkat
Robert
R
Department of Radiology, Poznań University of Medical Sciences, Szpital Kliniczny nr 1, Ul. Długa 1/2, Poznań, 61-848, Poland. radiologiamim@wp.pl
Pukacki
Fryderyk
F
Zarzecka
Anna
A
Kulesza
Jerzy
J
Majewski
Wacław
W
D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D019233:Retreatment; D015607:Stents; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior