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      Endovascular repair of delayed traumatic aortocaval fistula

      case-report
      Author(s): , MD, MS, FACC a , , MD, MPH, RPVI a , , MD, MS, FSIR b , , MD, FACS, FSVS c , ∗
      Publication date (Electronic):
      Journal: Journal of Vascular Surgery Cases and Innovative Techniques
      Publisher: Elsevier
      Keywords: Aortocaval fistula, ACF, Gunshot wound, Endovascular repair, High-output heart failure

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          Abstract

          Aortocaval fistula (ACF) is an uncommon condition that can result in a number of adverse clinical sequelae. We describe a case of an ACF that occurred several years after open repair of a penetrating injury of the abdominal aorta and inferior vena cava. Whereas ACF can have sudden and catastrophic presentations, our patient had a subacute presentation of high-output heart failure. We were able to fully correct the vascular injury and heart failure physiology and symptoms with endovascular therapy.

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          Aortocaval and iliac arteriovenous fistulas: recognition and treatment.

          David Brewster, Richard P Cambria, Ashby C. Moncure … (1991)
          Despite the well characterized physiologic effects of aortocaval or iliac arteriovenous fistulas, patients with such uncommon lesions may manifest a diverse array of symptoms, and diagnosis is often delayed or overlooked. To examine clinical features that facilitate recognition and allow successful repair, a 30-year experience with 20 such fistulas was reviewed. Fourteen fistulas were caused by aneurysm erosion, four followed iatrogenic injury during lumbar disk surgery, and two developed from abdominal gunshot wounds. The interval from presumed occurrence to diagnosis ranged from 3 hours to 8 years. The diagnosis was not recognized before surgery in five (25%) patients. Back pain (70%) was the most common symptom. The presence of a typical abdominal bruit (80%) was the most reliable physical finding, but its significance was occasionally overlooked or misinterpreted. Congestive heart failure was prominent in only seven (35%) patients. Severe lower extremity edema and mottling was the primary manifestation in eight cases, often causing initial confusion with venous thrombosis. Hematuria (5 patients) and oliguric renal failure (4 patients), both fully reversible after fistula repair, also caused diagnostic uncertainty. The mean preoperative cardiac output was 12.2 L/min, falling to 5.4 L/min with fistula repair. Mean blood loss was 5960 ml, supporting use of intraoperative autotransfusion. Two operative deaths (10%) occurred, both in patients not correctly diagnosed before surgery. Despite varied modes of presentation, prompt recognition and use of appropriate operative techniques should achieve successful repair.
          Article 0 comments Cited 30 times – based on 0 reviews     Review now
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            Endovascular stent-graft treatment of traumatic arterial lesions.

            Juan C Parodi, Claudio Schönholz, Luís M. Ferreira … (1999)
            Twenty-nine cases of post-traumatic false aneurysms and arteriovenous fistulas (AVF), with a mean follow-up of 24 months (1-65 months), are presented here. Diagnosis was established by color duplex and arteriogram. The time between injury and treatment varied between 3 days and 61 months. Endovascular treatment was accomplished using a covered Palmaz stent [vein, polytetrafluoroethylene (PTFE), or polyester], Corvita endoluminal graft, or a Wallgraft. Complimentary treatment of a branch injury was performed using a detachable balloon in one patient. The initial result was favorable for all patients. One case of asymptomatic stenosis of an iliac stent graft and three occlusions of the stent (one subclavian, one axillary, and one internal carotid) were registered during the follow-up period, and no clinical manifestations of the occlusions were reported. Endovascular treatment of post-traumatic false aneurysms and AVF appears to be a promising alternative for treatment of these lesions. Less pain and disability as well as rapid recovery time and lower cost after endovascular treatment compare favorably to the standard surgical technique.
            Article 0 comments Cited 25 times – based on 0 reviews     Review now
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              Aortocaval Fistula: Is Endovascular Repair the Preferred Solution?

              Kristine Clodfelter Orion, Robert Beaulieu, James Black (2016)
              To compare outcomes of open and endovascular repair of aortocaval fistulas (ACFs) in the setting of abdominal aortic aneurysms (AAAs).
              Article 0 comments Cited 15 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Peter J. Rossi
                Journal
                Journal ID (nlm-ta): J Vasc Surg Cases Innov Tech
                Journal ID (iso-abbrev): J Vasc Surg Cases Innov Tech
                Title: Journal of Vascular Surgery Cases and Innovative Techniques
                Publisher: Elsevier
                ISSN (Electronic): 2468-4287
                Publication date PMC-release: 13 November 2019
                Publication date Collection: December 2019
                Publication date (Electronic): 13 November 2019
                Volume: 5
                Issue: 4
                Pages: 467-471
                Affiliations
                [a ]Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisc
                [b ]Division of Vascular/Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisc
                [c ]Division of Vascular and Endovascular Surgery, Medical College of Wisconsin, Milwaukee, Wisc
                Author notes
                [∗ ]Correspondence: Peter J. Rossi, MD, FACS, FSVS, Chief, Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226 prossi@ 123456mcw.edu
                Article
                Publisher ID: S2468-4287(19)30092-9
                DOI: 10.1016/j.jvscit.2019.06.012
                PMC ID: 6859229
                SO-VID: afee973d-ece2-4565-a755-799f66a63235
                Copyright © © 2019 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 16 April 2019
                Date accepted : 25 June 2019
                Categories
                Subject: Case report

                Keywords: aortocaval fistula,acf,gunshot wound,endovascular repair,high-output heart failure
                Data availability:
                Keywords: aortocaval fistula, acf, gunshot wound, endovascular repair, high-output heart failure

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