Spontaneous aortocaval fistula due to abdominal aortic aneurysm rupture - a case report

Ramakantan, R; Peter, S. Babu; Swaminathan, TS; Chandrasekar, Viveksandeep Thoguluva

doi:10.4103/0971-3026.32245

Cited by 7 publications

(12 citation statements)

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“…The disease generally affects elderly men with an average age of 65 years. Smoking appears to be the risk factor most strongly associated with AAA [ 8 , 9 ]. The clinical signs and symptoms are quit variable that include abdominal pain, venous hypertension, lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest.…”

Section: Discussionmentioning

confidence: 99%

Endovascular management of aortocaval fistula complicating abdominal aortic aneurysm presenting as an acute renal failure

Esmat

Naseri

2021

Annals of Medicine and Surgery

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Introduction Aortocaval fistulas (ACFs) are a rare complication of abdominal aortic aneurysm (AAA), associated with high morbidity and mortality. It is thought that increased tension in the walls of large aneurysms can cause an inflammatory reaction resulting in adhesion to the adjacent vein and culminating in necrosis of the adherent layers and fistula formation. Presentation of case A 70-year-old male was referred from a local state center to the emergency department of our hospital, complaining of weakness and oliguria for two days. The laboratory analysis yielded high urea and creatinine levels, indicating an acute renal failure. Computed tomography images showed an aortocaval fistula complicating infrarenal abdominal aortic aneurysm. The patient was successfully managed with endovascular intervention. Discussion Aortocaval fistulas generally affect elderly men with an average age of 65 years. The diagnosis is often delayed because of the variable clinical manifestations, which increases the difficulties in treatment. Conventional surgical intervention has high mortality rates. However, endoleaks and paradoxical pulmonary embolism are the main concerning complications of endovascular treatment. Conclusion Spontaneous aortocaval fistulas are a rare, but potentially life-threatening complication of abdominal aortic aneurysm with myriad clinical manifestations. Early diagnosis and management can directly affect the prognosis and outcome. Modern non-invasive diagnostic imaging can help timely diagnosis and provide a road map for the treatment plan. Endovascular repair is the first choice of treatment. However, a high incidence and persistence of endoleak with the endovascular approach requires caution and a close long time follow up.

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Section: Discussionmentioning

confidence: 99%

Endovascular management of aortocaval fistula complicating abdominal aortic aneurysm presenting as an acute renal failure

Esmat

Naseri

2021

Annals of Medicine and Surgery

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“…Surgery is performed immediately, with closure of fistula done from the aneurismal sac or ligation of infrarenal IVC/iliac veins. Complications include dislodgement of atheromatous debri or embolization across the fistula leading to pulmonary embolism [24] . Endovascular treat- ment of these fistulas has also been reported [25] .…”

Section: Aorta To Ivc Fistulamentioning

confidence: 99%

Unusual fistulas and connections in the cardiovascular system: A pictorial review

Ghandour

Rajiah

2014

WJR

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A fistula is an abnormal vascular connection leading to diversion of blood from a high resistance arterial circuit to low resistance venous circuit. Coronary artery fistulas are abnormal communications of the coronary artery with a chamber of the heart, or with any segment of systemic or pulmonary circulation, bypassing the myocardial capillaries. Other unusual fistulas include connection between aorta and the right atrium/superior vena cava, aorta and the inferior vena cava or between a coronary artery bypass graft and a cardiac vein. Abnormal connections also include origin of the coronary artery from the pulmonary artery. In this article, we review the imaging, particularly computed tomography and magnetic resonance imaging of unusual fistulas and connections involving the cardiovascular system, particularly the coronary arteries and the aorta. Key words: Coronary; Artery; FistulaCore tip: Computed tomography and magnetic resonance imaging are very useful imaging modalities in determining the type and demonstrating the anatomy of these fistulas, which is essential for surgical/interventional planning. Careful analysis in multiple planes and three-dimensional reconstruction is required for comprehensive evaluation of fistulas. Treatment depends on the symptoms and the anatomy.

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“…Typically, the clinical presentation (including signs of high-output cardiac failure and an asymptomatic pulsatile abdominal mass) has been reported in 20-50% of human patients diagnosed with AVF. [3][4][5] Origin, size, localization, and evolution time of the fistula determine the degree of hemodynamic disturbances. The hemodynamic disturbances observed depend on arterial pressure at the site of arteriovenous connection and the velocity of shunting flow.…”

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confidence: 99%

“…[6][7][8] Arteriovenous fistulas deviate blood flow from high-resistance arterial to low-resistance venous systems and decrease peripheral vascular resistance and pressure inside the aorta, caudal to the fistula. 5,9 In addition, changes in blood volume are associated with relatively small changes in venous pressure attributable to the large systemic venous capacitance. 10 Decreased peripheral vascular resistance evokes physiologic responses resulting in volume overload and hyperdynamic circulation.…”

mentioning

confidence: 99%

“…14 velocities of 1.1 m/s in an aortocaval fistula in a human patient and 2.42 m/s in an aorticopulmonary fistula in a dog were reported previously. 5,14 Selective angiography is the gold-standard method used for the assessment of vascular anomalies before surgical intervention. 15,16 Computerized tomographic scan techniques have been developed to provide a noninvasive diagnostic method with 3-dimensional perspective that permits complete preoperative evaluation of the fistula.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Transarterial Coil Embolization of an Abdominal Aortocaval Fistula in a Dog

Nakata

Tanaka

Hamabe

et al. 2014

Veterinary Internal Medicne

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Spontaneous aortocaval fistula due to abdominal aortic aneurysm rupture - a case report

Cited by 7 publications

References 0 publications

Endovascular management of aortocaval fistula complicating abdominal aortic aneurysm presenting as an acute renal failure

Endovascular management of aortocaval fistula complicating abdominal aortic aneurysm presenting as an acute renal failure

Unusual fistulas and connections in the cardiovascular system: A pictorial review

Transarterial Coil Embolization of an Abdominal Aortocaval Fistula in a Dog

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