title: Aortocaval fistula formation due to ruptured abdominal aortic aneurysms: a 12-year series.
abstract: This study reports on the frequency and management of aortocaval fistulas (ACFs) in our department between 1998 and 2009. Overall frequency of ACFs among ruptured abdominal aortic aneurysms was 5.5%. Patients presented with low back pain (92.8%), abdominal tenderness (78.6%), hemorrhagic shock (28.6%), congestive heart failure (21.4%), dyspnea (42.8%), and palpitations (57.1%). The most reliable clinical sign was the presence of palpable pulsating abdominal mass (92.8%). Other clinical findings included increased central venous pressure (21.4%), lower extremity edema (71.4%), hematuria (21.4%), and scrotal edema (14.3%). Diagnosis was established preoperatively in 85.7% and intraoperatively in 14.3% of cases. Surgery was successful in promptly improving clinical signs and symptoms. Mortality rate was 7.1%. After a mean follow-up of 18.5 months, all surviving patients remained free from complications. In conclusion, ACFs represent a life-threatening emergency for vascular surgeons but can be successfully managed.
authors.affiliation: Department of Vascular Surgery, Red Cross Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kotsikoris
authors.forename: Theofanis T
authors.initials: TT
authors.lastname: Papas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papanas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Maras
authors.forename: Maria
authors.initials: M
authors.lastname: Andrikopoulou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Bessias
authors.forename: Stamatia
authors.initials: S
authors.lastname: Kotsiou
authors.forename: Efstratios
authors.initials: E
authors.lastname: Maltezos
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D001027:Aortography / Q000379:methods; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D006115:Greece; D006801:Humans; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D014656:Vascular Surgical Procedures; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery