Endovascular stent-graft repair of primary aortocaval fistula with an abdominal aortoiliac aneurysm

Lau, Louis; O’Reilly, M.J.G.; Johnston, L. C.; Lee, Bernard T.

doi:10.1067/mva.2001.111485

Cited by 60 publications

(54 citation statements)

References 24 publications

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“…Several reports have described successful EVAR of AAA with spontaneous aortocaval fistula. [239][240][241] Primary aortoenteric fistula. Primary aortoenteric fistula is a rare event often characterized by a classical triad of gastrointestinal bleeding, pain, and a pulsating mass that, in fact, is present in only a minority of patients.…”

Section: Unusual Aneurysmsmentioning

confidence: 99%

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

Chaikof

Brewster

Dalman

et al. 2009

Journal of Vascular Surgery

636

520

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DEFINITION OF THE PROBLEM Purpose of these guidelinesThe Clinical Practice Council of the Society for Vascular Surgery charged a writing committee with the task of updating practice guidelines, initally published in 2003, for surgeons and physicians who are involved in the preoperative, operative, and postoperative care of patients with abdominal aortic aneurysms (AAA). 1 This document provides recommendations for evaluating the patient, including risk of aneurysm rupture and associated medical co-morbidities, guidelines for selecting surgical or endovascular intervention, intraoperative strategies, perioperative care, long-term follow-up, and treatment of late complications.Decision making related to the care of patients with AAA is complex. Aneurysms present with varying risks of rupture and patient specific factors influence anticipated life expectancy, operative risk, and the need to intervene. Careful attention to the choice of operative strategy, as influenced by anatomic features of the AAA, along with optimal treatment of medical co-morbidities is critical to achieving excellent outcomes. Moreover, appropriate postoperative patient surveillance and timely intervention in the case of a late complication is necessary to minimize subsequent aneurysm-related death or morbidity. All of these clinical decisions are determined in an environment where cost-effectiveness will ultimately dictate the ability to provide optimal care to the largest possible segment of the population. Currently available clinical data sets have been reviewed in formulating these recommendations. However, an important goal of this document is to clearly identify those areas where further clinical research is necessary. Methodology and evidenceA comprehensive review of the available clinical evidence in the literature was conducted in order to generate a concise set of recommendations. The strength of any given recommendation and the quality of evidence was scored based on the GRADE system (Table I). 2 When the benefits of an intervention outweighed its risks, or, alternatively, risks outweighed benefits, a strong recommendation was noted. However, if benefits and risks were less certain, either because of low quality evidence or because high quality evidence suggests benefits and risks are closely balanced, a weak recommendation was recorded. The quality of evidence that formed the basis of these recommendations was scored as high, moderate, or low. Not all randomized controlled trials are alike and limitations may compromise the quality of their evidence. In addition, if there is a large magnitude of effect, the quality of evidence derived from observational studies may be high. Thus, quality of evidence was scored as high when additional research is considered very unlikely to change confidence in the estimate of effect; moderate when further research is likely to have an important impact in the estimate of effect; or low when further research is very likely to change the estimate of the effect.

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Section: Unusual Aneurysmsmentioning

confidence: 99%

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

Chaikof

Brewster

Dalman

et al. 2009

Journal of Vascular Surgery

636

520

View full text Add to dashboard Cite

show abstract

“…21 A hemodynamic alteration described by Lau et al was sudden increase of peripheral vascular resistance, caused by abrupt fall of cardiac output after AVF occlusion with stent-graft release. 22 This leads to hard-to-control hypertension. Such change is not common in open surgery due to aortic clamping and bleeding.…”

Section: Discussionmentioning

confidence: 99%

Aneurisma ilíaco associado a fístula arteriovenosa

Pinto

Júnior²,

Lopes

et al. 2007

J. vasc. bras.

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Rupture of aortoiliac aneurysms into the iliac vein or vena cava is an uncommon complication. Many signs and symptoms develop as a result of venous hypertension, which makes preoperative diagnosis difficult, such as leg edema, dyspnea, hematuria, signs of renal or cardiac insufficiency. Abdominal bruit, associated with pulsatile mass and abdominal pain, is the key for clinical diagnosis. Preoperative recognition of arteriovenous fistula is important for surgical planning. We report a case of right internal and common iliac artery aneurysm associated with fistula into the common iliac vein. Initial symptoms were right leg edema and dyspnea, which induced to the incorrect diagnosis of deep vein thrombosis.Keywords: Iliac aneurysm, arteriovenous fistula, ruptured aneurysm. RESUMOA ruptura dos aneurismas aorto-ilíacos para a veia ilíaca ou veia cava é uma complicação pouco comum. A hipertensão venosa leva a vários sinais e sintomas, o que dificulta o diagnóstico pré-operatório, tais como edema do membro inferior, dispnéia, hematúria, sinais de insuficiência renal ou cardíaca. Sopro abdominal é a chave do diagnóstico clínico, associado à massa pulsátil e dor abdominal. O reconhecimento da fístula arteriovenosa no pré-operatório é importante para o planejamento cirúrgico. Relatamos um caso de aneurisma da artéria ilíaca comum e interna direita associado a fístula para veia ilíaca comum, cursando, inicialmente, com edema do membro inferior direito e dispnéia, o que levou ao diagnóstico incorreto de trombose venosa profunda. Palavras-chave:Aneurisma ilíaco, fístula arteriovenosa, aneurisma roto.

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“…4,7,8,10,11 However, open repair has been associated with a mortality rate of 30% and significant morbidities reported, including limb loss, ischemia, caval thrombosis, pulmonary embolus, myocardial infarction, and severe bleeding from engorged retroperitoneal veins. 4,12,13 In recent years, the advance of interventional radiology has made more and more cases treated by the endovascular repair. The advantage is less invasive, with less pain and blood loss, and shorter hospital stay.…”

Section: Case Reportmentioning

confidence: 99%

Successful coil embolization of an unusual aorto-superior mesenteric vein fistula

Hii

Yeh

et al. 2009

Journal of Vascular Surgery

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The aortovenous fistulas are rare, most of them are aortocaval fistula. The non-caval communication of the fistula is sparse. Herein we report a 47-year-old female diagnosed as traumatic aorto-superior mesenteric vein (Ao-SMV) fistula. The abdominal pain, fullness, and frank bruit on abdominal auscultation suggested the diagnosis of an intra-abdominal arteriovenous fistula. The diagnosis of Ao-SMV was further confirmed by the computed tomography (CT) and aortography. The fistula was successfully treated with transcatheter coil embolization. This is the first case of Ao-SMV fistula. It provides an alternative option of treatment other than conventional surgery.

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Endovascular stent-graft repair of primary aortocaval fistula with an abdominal aortoiliac aneurysm

Cited by 60 publications

References 24 publications

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

Aneurisma ilíaco associado a fístula arteriovenosa

Successful coil embolization of an unusual aorto-superior mesenteric vein fistula

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