Endovascular treatment of ruptured abdominal aortic aneurysm with aortocaval fistula.
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.
Guzzardi
Giuseppe
G
Institute of Interventional Radiology, Maggiore della Carità Hospital, Corso Mazzini 18, 28100 Novara, Italy. guz@libero.it
Fossaceca
Rita
R
Divenuto
Ignazio
I
Musiani
Antonello
A
Brustia
Piero
P
Carriero
Alessandro
A
D000368:Aged; D001011:Aorta / Q000002:abnormalities; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D003287:Contrast Media; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011856:Radiographic Image Enhancement / Q000379:methods; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D016306:Vena Cava Filters; D014684:Venae Cavae / Q000002:abnormalities / Q000000981:diagnostic imaging
D003287:Contrast Media