Open Repair of Inflammatory Abdominal Aortic Aneurysm and Aortocaval Fistula Using Retrograde Balloon Occlusion

Madani, Amin; Leung, Steven S.; Obrand, Daniel I.

doi:10.1177/1538574413508828

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…Unresolved issues in open repair, which was performed in our study, include the control of venous bleeding and the prevention of pulmonary embolisms caused by debris or air. In the present case, a balloon occlusion catheter was used to minimize intraoperative bleeding from the fistula, as previously reported [12,14] . Bleeding from the AVF can usually be controlled via digital compression.…”

Section: Discussionmentioning

confidence: 86%

“…Consequently, the correct diagnosis is made in only 37–52% of cases before surgery [11] . Several case reports recommend the use of CT or duplex ultrasound as a means of diagnosing AVFs [12,13] . Any combination of imaging modalities, such as contrast-enhanced CT and abdominal ultrasonography, as used in this case, are useful, especially for regional diagnosis of AVF.…”

Section: Discussionmentioning

confidence: 99%

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Successful surgical repair of an ilio-iliac arteriovenous fistula associated with a ruptured common iliac artery aneurysm

Iijima

Kawasaki

Ishibashi

2015

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Successful surgical repair of an ilio-iliac arteriovenous fistula associated with a ruptured common iliac artery aneurysm

Iijima

Kawasaki

Ishibashi

2015

International Journal of Surgery Case Reports

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“…Most patients undergoing an open repair had primary repair of the ACF from within the sac. Espinel et al 11 and Madani et al 46 used a retrograde balloon occlusion of the inferior vena cava (IVC) for venous control before primarily repairing the ACF. Four patients were repaired with a patch angioplasty of the IVC.…”

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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“…9,14 Occlusion of the IV or ICV with a balloon catheter inserted through the femoral vein has been used to prevent massive bleeding. 1,9,10 Espinel et al 1 suggested that this strategy should be routinely considered for open surgical repair of aortocaval fistulas.…”

Section: Discussionmentioning

confidence: 99%

“…Catastrophic or lethal blood loss from inferior vein cava (IVC) or iliac vein (IV) can be controlled by digital or manual compression within the aneurismal sac, open vein clamping, or endovascular vein occlusion proximal and distal to the fistula. 1,6,9,10…”

Section: Introductionmentioning

confidence: 99%

Endovascular Occlusion of Iliocaval Confluence During Surgical Repair of Iliocaval Fistula due to Ruptured Abdominal Aortoiliac Aneurysm

Tenezaca-Sari

García

Gil-Sala

et al. 2022

Vasc Endovascular Surg

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We describe the successful use of endovascular occlusion of the iliocaval confluence to prevent excessive bleeding during open repair of an iliocaval arteriovenous fistula due to a ruptured abdominal aortoiliac aneurysm. A 70-year-old man was admitted with chest pain, hemodynamic instability, acute pulmonary edema, and bilateral leg swelling. Computed tomography angiography (CTA) showed a ruptured AAIA with a large primary iliocaval fistula. Aortobifemoral bypass with a Dacron bifurcated prosthetic graft was performed with catheter balloon occlusion of the iliocaval confluence to prevent massive bleeding. Follow-up CTA showed no complications. Iliocaval fistula is a rare complication of AAIA that requires emergent surgery. Endovascular occlusion of iliac or inferior cava vein can control bleeding.

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Open Repair of Inflammatory Abdominal Aortic Aneurysm and Aortocaval Fistula Using Retrograde Balloon Occlusion

Abstract: Retrograde balloon occlusion of the inferior vena cava can be used to control hemorrhage during the open repair of an ACF, especially in the challenging setting of an inflammatory AAA.

Cited by 8 publications

References 14 publications

Successful surgical repair of an ilio-iliac arteriovenous fistula associated with a ruptured common iliac artery aneurysm

Successful surgical repair of an ilio-iliac arteriovenous fistula associated with a ruptured common iliac artery aneurysm

Aortocaval Fistula: Is Endovascular Repair the Preferred Solution?

Endovascular Occlusion of Iliocaval Confluence During Surgical Repair of Iliocaval Fistula due to Ruptured Abdominal Aortoiliac Aneurysm

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