title: Inferior vena cava thrombosis following endovascular repair of acute aortocaval fistula: a word of caution.
abstract: Acute aortocaval fistula (ACF) is a rare, life-threatening condition with a complex clinical presentation, making prompt diagnosis challenging. Primary ACF is believed to be associated with abdominal aortic aneurysm (AAA) rupture in 80% of the cases. Thrombotic complications following endovascular repair for acute ACF are rare and less widely recognized. A high index of suspicion is required for diagnosis of this postoperative complication. We describe a novel, staged management approach using endovascular aortic stent grafts (Gore Excluder; Flagstaff, CA) in both the abdominal aorta and the inferior vena cava (IVC) in a patient with a ruptured AAA and acute ACF with subsequent acute IVC thrombosis.
authors.affiliation: The Doctor's Clinic, Silverdale, WA, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Bernstein
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Jimenez
mesh_terms: D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D057510:Endovascular Procedures / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D007084:Iliac Vein / Q000601:surgery; D008297:Male; D010690:Phlebography / Q000379:methods; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
keywords: abdominal aortic aneurysm; aortocaval fistula; endovascular aneurysm repair; inferior vena cava occlusion