Total endovascular management of ruptured aortocaval fistula: Technical challenges and case report

Mohammed Elkassaby; Mahmoud Alawy; Mohamed Zaki; Niamh Hynes; Wael Tawfick; Sherif Sultan

doi:10.1177/1708538113499018

Total endovascular management of ruptured aortocaval fistula: Technical challenges and case report

Mohammed Elkassaby, Mahmoud Alawy, Mohamed Zaki, Niamh Hynes, Wael Tawfick, Sherif Sultan

Research output: Contribution to a Journal (Peer & Non Peer) › Article › peer-review

13 Citations (Scopus)

Abstract

Purpose: Primary aortocaval fistula (ACF) is a rare complication of ruptured abdominal aortic aneurysms (rAAA). Endovascular repair for rAAA (REVAR) provides an efficient, elegant and safe option, minimizing the risk of massive bleeding with open repair.

Case report: Case 1: An 84-year-old man presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure, pulmonary and renal impairment. An endovascular aortic aneurysm repair was undertaken and a bifurcated stent graft was deployed to treat the aneurysm and a second stent graft was deployed within the inferior vena cava to simultaneously seal the rAAA and the ACF. Case 2: A 73-year-old male patient presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure and renal impairment with haematuria. REVAR was the plan for management. A bifurcated stent graft was used to treat the aneurysm and another bifurcated stent graft was placed within the inferior vena cava to seal the rAAA and the ACF.

Conclusion: Here in, we report the first two cases in the English literature of rAAA with ACF successfully managed with simultaneous endovascular stent-grafting of both the aorta and the inferior vena cava.

Original language	English
Pages (from-to)	306-309
Number of pages	4
Journal	Vascular
Volume	22
Issue number	4
DOIs	https://doi.org/10.1177/1708538113499018
Publication status	Published - 1 Aug 2014
Externally published	Yes

Keywords

Abdominal aortic aneurysm
Aortocaval fistula
EVAR
Rupture

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abstract = "Purpose: Primary aortocaval fistula (ACF) is a rare complication of ruptured abdominal aortic aneurysms (rAAA). Endovascular repair for rAAA (REVAR) provides an efficient, elegant and safe option, minimizing the risk of massive bleeding with open repair.Case report: Case 1: An 84-year-old man presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure, pulmonary and renal impairment. An endovascular aortic aneurysm repair was undertaken and a bifurcated stent graft was deployed to treat the aneurysm and a second stent graft was deployed within the inferior vena cava to simultaneously seal the rAAA and the ACF. Case 2: A 73-year-old male patient presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure and renal impairment with haematuria. REVAR was the plan for management. A bifurcated stent graft was used to treat the aneurysm and another bifurcated stent graft was placed within the inferior vena cava to seal the rAAA and the ACF.Conclusion: Here in, we report the first two cases in the English literature of rAAA with ACF successfully managed with simultaneous endovascular stent-grafting of both the aorta and the inferior vena cava.",

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AU - Alawy, Mahmoud

AU - Zaki, Mohamed

AU - Hynes, Niamh

AU - Tawfick, Wael

AU - Sultan, Sherif

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N2 - Purpose: Primary aortocaval fistula (ACF) is a rare complication of ruptured abdominal aortic aneurysms (rAAA). Endovascular repair for rAAA (REVAR) provides an efficient, elegant and safe option, minimizing the risk of massive bleeding with open repair.Case report: Case 1: An 84-year-old man presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure, pulmonary and renal impairment. An endovascular aortic aneurysm repair was undertaken and a bifurcated stent graft was deployed to treat the aneurysm and a second stent graft was deployed within the inferior vena cava to simultaneously seal the rAAA and the ACF. Case 2: A 73-year-old male patient presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure and renal impairment with haematuria. REVAR was the plan for management. A bifurcated stent graft was used to treat the aneurysm and another bifurcated stent graft was placed within the inferior vena cava to seal the rAAA and the ACF.Conclusion: Here in, we report the first two cases in the English literature of rAAA with ACF successfully managed with simultaneous endovascular stent-grafting of both the aorta and the inferior vena cava.

AB - Purpose: Primary aortocaval fistula (ACF) is a rare complication of ruptured abdominal aortic aneurysms (rAAA). Endovascular repair for rAAA (REVAR) provides an efficient, elegant and safe option, minimizing the risk of massive bleeding with open repair.Case report: Case 1: An 84-year-old man presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure, pulmonary and renal impairment. An endovascular aortic aneurysm repair was undertaken and a bifurcated stent graft was deployed to treat the aneurysm and a second stent graft was deployed within the inferior vena cava to simultaneously seal the rAAA and the ACF. Case 2: A 73-year-old male patient presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure and renal impairment with haematuria. REVAR was the plan for management. A bifurcated stent graft was used to treat the aneurysm and another bifurcated stent graft was placed within the inferior vena cava to seal the rAAA and the ACF.Conclusion: Here in, we report the first two cases in the English literature of rAAA with ACF successfully managed with simultaneous endovascular stent-grafting of both the aorta and the inferior vena cava.

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KW - Rupture

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Total endovascular management of ruptured aortocaval fistula: Technical challenges and case report

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