Primary Aortocaval Fistula and Juxtarenal Aortic Aneurysm

A 71-year-old man with hypertension presented with abdominal pain and dyspnoea; he had an 8-cm juxtarenal abdominal aortic aneurysm (unsuitable for standard endovascular aneurysm repair, owing to saccular outpouching of the immediate infrarenal area; arrow in [A]). Physical examination revealed signs of right heart failure: bilateral ankle oedema, hepatomegaly and right pleural effusion. An aortocaval fistula was noticed on computed tomographic angiography. Following suprarenal aortic clamping and distal inferior vena cava balloon control, an aorto-bi-iliac Dacron graft was implanted with primary closure of the fistula (B) from the aortic side.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Coup D'Oeil Source Type: research