Type III endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava, treated by endovascular approach

Autor: Giovana Battaglia, Guilherme Holtz Schuch, Aline Riquena da Silva, Artur Jose Gaspar Merlini, Nayara Marja Gil, Sergio Vitasovic Gomes, Flávia Coura da Silva, Lucas Azevedo Portela, Fábio José Bonafé Sotelo
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Annals of Vascular Surgery - Brief Reports and Innovations, Vol 2, Iss 2, Pp 100081- (2022)
Druh dokumentu: article
ISSN: 2772-6878
DOI: 10.1016/j.avsurg.2022.100081
Popis: Aortocaval fistulas (ACFs) are rare complications of abdominal aortic aneurysms (AAA), with an incidence of 0.22% to 6.04%, associated with a significant increase in mortality rate because of both their direct clinical repercussion and the technical difficulty involved in their treatment. Owing to technical limitations related to the open treatment of AAA with ACFs, as well as their associated morbidity and mortality rates, endovascular treatment is an important option to consider.However, under such clinical situations, the morphology of the aneurysm and the possibility of endoleak may present as limitations to an endovascular approach, as the endoleak is seen as the most frequent complication in the treatments of AAAs.Herein, we report the case of a patient who underwent endovascular treatment with an endoprosthesis for an infrarenal abdominal aortic aneurysm fistulized to the inferior vena cava, associated with a type III endoleak correction.The hemodynamic behavior of the fistula described in this case resembled that of a high-output fistula. ACF diagnosis is preferably made by contrast computed tomography, where early presence of contrast in the venous system and loss of space or abnormal communication is detected between the two vessels involved; in this case, the abdominal aorta and inferior vena cava (IVC). The treatment is surgery through ACF and aneurysm repair. We report the case of a patient who underwent endovascular correction of AAA with ACF, and presented, after 4 months, with the need for reintervention due to a type III endoleak. This case shows two complications in the same patient, a rare situation in the medical literature.
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