Percutaneous fenestrated endovascular aortic graft treatment of aortocaval fistula with aortic pseudoaneurysms secondary to penetrating trauma

Abstract

Aortocaval fistula (ACF) is a lethal complication of aortic aneurysmal disease. Traditional treatment of ACF involves open surgical approaches to fistula ligation and repair of the great vessels, with a high mortality secondary to bleeding and cardiac compromise. We present the case of a 28-year-old man with a chronic ACF with concomitant aortic pseudoaneurysms secondary to penetrating trauma treated with a fenestrated endograft.

Use of an AFX aortic cuff in the endovascular treatment of aortocaval fistula secondary to abdominal aortic pseudoaneurysm

“…Aortocaval fistula (ACF) is a rare and lethal finding . ACF is usually primary in origin due to an enlarging abdominal aortic aneurysm (AAA) that erodes into the venous wall, but it can be secondary to previous abdominal surgery or penetrating trauma . Moreover, ACF can be deadly in up to 60% of patients because it can cause high‐output cardiac failure or ruptured aneurysm .…”

“…ACF is usually primary in origin due to an enlarging abdominal aortic aneurysm (AAA) that erodes into the venous wall, but it can be secondary to previous abdominal surgery or penetrating trauma . Moreover, ACF can be deadly in up to 60% of patients because it can cause high‐output cardiac failure or ruptured aneurysm . Findings on physical examination usually include abdominal bruit or thrill, a pulsatile mass, and signs of heart failure .…”

“…Moreover, ACF can be deadly in up to 60% of patients because it can cause high‐output cardiac failure or ruptured aneurysm . Findings on physical examination usually include abdominal bruit or thrill, a pulsatile mass, and signs of heart failure . Historically, surgical repair was the primary approach, followed more recently by endovascular intervention .…”