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

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 t...

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Main Authors: 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
Format: Article
Language:English
Published: Elsevier 2022-06-01
Series:Annals of Vascular Surgery - Brief Reports and Innovations
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772687822000435
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author 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
author_facet 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
author_sort Giovana Battaglia
collection DOAJ
description 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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spelling doaj.art-47d3826a2eac43109ec44aa6d5413de92023-07-04T05:11:46ZengElsevierAnnals of Vascular Surgery - Brief Reports and Innovations2772-68782022-06-0122100081Type III endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava, treated by endovascular approachGiovana Battaglia0Guilherme Holtz Schuch1Aline Riquena da Silva2Artur Jose Gaspar Merlini3Nayara Marja Gil4Sergio Vitasovic Gomes5Flávia Coura da Silva6Lucas Azevedo Portela7Fábio José Bonafé Sotelo8Universidade Nove de Julho, São Paulo, SP; Corresponding author at: Rua Adelino Luis Bataglia, 19 – Vila Borges, Santa Bárbara d'Oeste, São Paulo, SP, CEP 13450319.Universidade Nove de Julho, São Paulo, SPHospital Ipiranga´s Vascular Surgery departament, São Paulo, SPHospital Ipiranga´s Vascular Surgery departament, São Paulo, SPHospital Ipiranga´s Vascular Surgery departament, São Paulo, SPHospital Ipiranga´s Vascular Surgery departament, São Paulo, SPHospital Ipiranga´s Vascular Surgery departament, São Paulo, SPHospital Ipiranga´s Vascular Surgery departament, São Paulo, SPHospital Ipiranga´s Vascular Surgery departament, São Paulo, SPAortocaval 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.http://www.sciencedirect.com/science/article/pii/S2772687822000435Fusiform abdominal aortic aneurysmaortocaval fistulaendoleakendovascular approach
spellingShingle 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
Type III endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava, treated by endovascular approach
Annals of Vascular Surgery - Brief Reports and Innovations
Fusiform abdominal aortic aneurysm
aortocaval fistula
endoleak
endovascular approach
title Type III endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava, treated by endovascular approach
title_full Type III endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava, treated by endovascular approach
title_fullStr Type III endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava, treated by endovascular approach
title_full_unstemmed Type III endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava, treated by endovascular approach
title_short Type III endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava, treated by endovascular approach
title_sort type iii endoleak in a patient with fusiform abdominal aortic aneurysm fistulized to the inferior vena cava treated by endovascular approach
topic Fusiform abdominal aortic aneurysm
aortocaval fistula
endoleak
endovascular approach
url http://www.sciencedirect.com/science/article/pii/S2772687822000435
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