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

Abstract

HighlightsWe report the successful surgical treatment of an ilio-iliac arteriovenous fistula.Although rare, this disease can be life-threatening.Use of multiple imaging modalities facilitates correct preoperative diagnosis.Balloon occlusion technique is used to minimize blood loss during open repair.There was no sign of high-output heart failure because of venous flow failure.

An Ilio-iliac Arteriovenous Fistula Following Spontaneous Rupture of a Right Common Iliac Artery Aneurysm

“…1,4 The predominant concern following endovascular repair is communication between the aneurysm sac and adjacent vein resulting in a persistent Type 2 endoleak. 12 As demonstrated in this case study, we hypothesise that this persistent communication is unlikely to result in sac expansion because of the low-pressure venous outflow resistance following endovascular repair. Furthermore, given the low flow state present postoperatively, it is likely that the hyperdynamic effects of a highoutput fistula will not be clinically significant following restoration of normal cardiac status and renal function.…”

“…venous bleeding control, embolisation of aneurysmal debris through the arteriovenous fistula and also physiological stress secondary to the pre-existing hyperdynamic state with cardiac decompensation. 1,9,12 Endovascular repair has become increasingly common, given it is less invasive and has a lower risk of major intra-procedural blood loss. Whether it can be carried out depends on favourable anatomy and the haemodynamic stability of the patient.…”

Same features, different diagnosis: A case of ilio-iliac arteriovenous fistula presenting as decompensated heart failure

“…The diagnosis remains unestablished in almost half the cases of Iliac and aortic arteriovenous fistulae. 8 , 9 This is probably due to unusual presentations of these patients going through a few working diagnoses before the final diagnosis of arteriovenous fistula and acquiring a presumed clinical urgency by then. Abdominal bruit was the most consistent feature in such patients and yet was frequently overlooked.…”

Blood pressure shifts resulting from a concealed arteriovenous fistula associated with an iliac aneurysm: a case report

“…An AVF associated with an AAA has the following triad of symptoms: congestive heart failure, continuous abdominal bruit, and a pulsating abdominal mass [ 1 ]; however, these symptoms are noted in only 20–50 % of reported cases [ 4 ]. An AVF associated with a SIA might show lower limb edema as an additional feature; however, many cases do not have hemodynamic symptoms [ 4 – 6 ]. Definite diagnosis of an AVF offers advantages for surgical and anesthetic management.…”

“…CT has been recommended to determine the subtypes, sizes, and complications of aneurysms [ 1 , 3 – 6 ]. CT can contribute to the detection of an asymptomatic AVF associated with a SIA [ 4 – 6 ]. Although our case had hemodynamic catastrophe, the CT findings in our case were much fewer than the findings presented in previous reports.…”