title: Endovascular stent-graft repair of spontaneous aorto-caval fistula secondary to a ruptured abdominal aortic aneurysm: An emergency management of hostile anatomy.
abstract: OBJECTIVE
  Although endovascular aneurysm repair of aorto-caval fistula offers a safe and efficient approach compared to traditional open repair, endovascular techniques for the treatment of aorto-caval fistula with ruptured abdominal aortic aneurysms in emergency circumstance are not well established. This study aims to evaluate the effect of endovascular repair of aorto-caval fistula of a patient with ruptured abdominal aortic aneurysm and hostile anatomy.
  
  
  METHODS
  we report a case of an aorto-caval fistula endovascular repaired in a 78-year-old male using a hybrid stent-graft technique.
  
  
  RESULTS
  The patient had an uneventful recovery and CTA follow up showed no sign of ACF or any endoleak.
  
  
  CONCLUSIONS
  This case highlights ACF might be managed by composite endograft implantation with careful and solid sealing of anchoring zones on the two sides.
authors.affiliation: Peking University Health Science Center and Department of Vascular Surgery, Peking University People's Hospital, Beijing, The People's Republic of China.
authors.forename: Mingyuan
authors.initials: M
authors.lastname: Liu
authors.affiliation: Division of surgery, The medical school of Qingdao University, Department of Vascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China.
authors.forename: Haofu
authors.initials: H
authors.lastname: Wang
keywords: Endovascular aneurysm repair; aorto-caval fistula; hostile anatomy; hybrid stent-graft; ruptured abdominal aortic aneurysm; tortuous iliac access