Key result
Staged triple endovascular approach closes persistent aortocaval fistula via caval and aortic exclusion.
Why the study?
Primary aortocaval fistula is a rare complication of abdominal aortic aneurysms presenting unique surgical challenges, with open and endovascular techniques differing in perioperative mortality and recurrence rates.
Case Report (n=1)
A staged triple endovascular approach offers a potential technique for closing persistent aortocaval fistulas secondary to ruptured abdominal aortic aneurysms.
Persistent ACF after endovascular repair warrants intraoperative vigilance; leaves open optimal technique selection in this rare entity.
A primary aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysms caused by erosion of the aortic wall into the vena cava. It is more frequently observed in the setting of ruptured abdominal aortic aneurysms and presents a unique challenge for vascular surgeons. Both open and endovascular techniques exist, with the main differences being perioperative mortality and recurrence rates. We present a case of an ACF diagnosed intraoperatively, which persisted after endovascular aneurysm repair in conjunction with a type II endoleak. We applied a unique staged, triple endovascular approach to close the ACF via caval and aortic exclusion of inflow and outflow vessels.
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Mcdonald et al. (2023) conducted a case report in Aortocaval fistula secondary to ruptured abdominal aortic aneurysm (n=1). Staged, triple endovascular approach was evaluated on Closure of the aortocaval fistula. A staged, triple endovascular approach was applied to close a persistent aortocaval fistula via caval and aortic exclusion of inflow and outflow vessels.
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