Abstract
A ruptured abdominal aortic aneurysm (RAAA), complicated by an aortocaval fistula (ACF), is usually associated with high morbidity and mortality during open operative repair. We report a case of endovascular treatment of an RAAA with ACF. After accessing both common femoral arteries, a bifurcated aortic stent graft was placed. Subsequently, we accessed the fistula from the right femoral vein and a cava vein angiography showed a persistent massive flow from the cava to the excluded aneurysm sac. We proceeded by covering the fistula with an Excluder aortic stent-graft cuff to prevent pressurization of the aneurysm sac and secondary endoleaks. This procedure is feasible and may reduce the chances of posterior endoleaks.
Copyright © 2014 Elsevier Inc. All rights reserved.
MeSH terms
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Aged
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Aorta / physiopathology
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Aorta / surgery*
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Aortic Aneurysm, Abdominal / complications
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Aortic Aneurysm, Abdominal / diagnosis
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Aortic Aneurysm, Abdominal / physiopathology
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Aortic Aneurysm, Abdominal / surgery*
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Aortic Rupture / diagnosis
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Aortic Rupture / etiology
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Aortic Rupture / physiopathology
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Aortic Rupture / surgery*
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Aortography / methods
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Arteriovenous Fistula / diagnosis
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Arteriovenous Fistula / etiology
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Arteriovenous Fistula / physiopathology
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Arteriovenous Fistula / surgery*
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Blood Vessel Prosthesis
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Blood Vessel Prosthesis Implantation* / instrumentation
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Endovascular Procedures* / instrumentation
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Hemodynamics
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Humans
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Male
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Phlebography / methods
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Stents
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Tomography, X-Ray Computed
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Treatment Outcome
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Vena Cava, Inferior / diagnostic imaging
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Vena Cava, Inferior / physiopathology
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Vena Cava, Inferior / surgery*