A giant aortocaval fistula due to abdominal aortic aneurysm

İriz, Erkan; Özdoğan, Mehmet; Erer, Dilek; Uslu, Murat; Köksal, Pinar; Kurtipek, Ömer

doi:10.1016/j.ijcard.2006.03.075

Cited by 14 publications

(16 citation statements)

References 5 publications

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“…In fact, aortocaval fistulae are probably missed in 50% of patients44 and are discovered accidentally during elective repair of AAA 43. Trauma and surgery of the lumbar spine are other known causes of aortocaval fistulae 43 45…”

Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

“…Thus, temporary or permanent closure of this communication by an aortic mural thrombus or by a compressing aneurysm will change the clinical picture 45. Clinically, a patient with an aortocaval fistula presents with a classical triad of abdominal or back pain, a pulsatile abdominal mass, and a continuous bruit on abdominal auscultation 43 45 46. This triad is reported in 50–90% of patients in one series 46.…”

Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

“…Patients with an aortocaval fistula may also present with manifestations of high output heart failure such as dyspnoea, tachycardia, wide pulse pressure, cyanosis, and lower limb oedema 33 43 45 47. Additional symptoms and signs include angina,45 palpitations,48 hypotension, fever,44 oliguria,44 46 haematuria,43 44 49 pulsatile peripheral veins,45 and diminished lower limb pulses 8 32 44 45…”

Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

“…Thus, unless the patient presents in extremis due to the rupture, every effort should be made to detect the fistula preoperatively 43 – 45. Abdominal CT scan is the definitive imaging test for the evaluation of AAA, and all patients suspected of having an aortocaval fistula should undergo a contrast CT whenever possible.…”

Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

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Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations

Assar

Zarins²

2009

Postgraduate Medical Journal

137

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Ruptured abdominal aortic aneurysm (AAA) is one of the most fatal surgical emergencies, with an overall mortality rate of 90%. Most AAAs rupture into the retroperitoneal cavity, which results in the classical triad of pain, hypotension, and a pulsatile mass. However, this triad is seen in only 25-50% of patients, and many patients with ruptured AAA are misdiagnosed. It is likely that different sites of rupture of AAA determine a variety of common and uncommon clinical presentations, the recognition of which can save many lives. This article reviews the different sites of rupture of infrarenal AAA and explores the evidence behind the various clinical presentations seen in patients with ruptured AAA.

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Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

See 2 more Smart Citations

Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations

Assar

Zarins²

2009

Postgraduate Medical Journal

137

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“…Four patients were repaired with a patch angioplasty of the IVC. 8,9,12 Endovascular repair included several endograft types: Boston Scientific (Natick, MA), Gore (Flagstaff, CA), Cook (Bloomington, IN), Edwards Lifescience (Irvine, CA), Medtronic (Minneapolis, MN), and La Maitre (Burlington, MA).…”

Section: Resultsmentioning

confidence: 99%

Aortocaval Fistula: Is Endovascular Repair the Preferred Solution?

Orion

Beaulieu

Black

2016

Annals of Vascular Surgery

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Background To compare outcomes of open and endovascular repair of aortocaval fistulas (ACFs) in the setting of abdominal aortic aneurysms (AAAs). Methods A literature review was undertaken on Pubmed from 1999 to 2014 to identify reported cases of both endovascular and open repair of ACF, including the index case, presented here. Primary outcomes for endovascular repair were: complications, presence of endoleak, and death. Primary outcomes for open repair were: complications and death. Results Forty articles were reviewed with a total of 67 patients, including the index case. Endovascular approach was used in 26 patients (39%). Endoleaks were present in 50%, whereas similarly 46% of patients had a reported complication. Five deaths (19%) occurred in the endovascular group. Open repair was performed in 41 cases (61%). The rate of complication and the death in open repair were 36% and 12%, respectively (P = 0.327 and P = 0.910, respectively) compared with endovascular. Mean follow-up was 7.7 months for the endovascular group and 8.5 months in the open group. Conclusions Previous demonstrations of high morbidity and mortality with open repair of ACF in the setting of AAA have motivated endovascular approaches. However, endoleaks are a significant problem and were present in 50% of ACF cases. The continued presence of an endoleak in the setting of an ACF may result in persistence of the ACF, unlikely thrombosis of the endoleak, and continued sac enlargement. Endovascular repair presents theoretical benefit, yet is not associated with a reduced rate of complication or death versus open repair in this contemporary review.

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Tran

2017

Ruptured Abdominal Aortic Aneurysm

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A giant aortocaval fistula due to abdominal aortic aneurysm

Cited by 14 publications

References 5 publications

Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations

Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations

Aortocaval Fistula: Is Endovascular Repair the Preferred Solution?

Background Scope of the Problem

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