Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202200171
Jornal Vascular Brasileiro
Therapeutic Challenge

Fístula arteriovenosa ilíaca à direita por rotura de aneurisma e aneurisma de artéria ilíaca esquerda: tratamento híbrido

Right iliac arteriovenous fistula due to aneurysm rupture and left iliac artery aneurysm: hybrid treatment

Adalberto Pereira de Araujo; Cristiane Ferreira de Araujo Gomes; Douglas Poschinger-Figueiredo; Carlos Felipe da Silva Delgado; Monica Rochedo Mayall; Flavia Figueira Baltharejo Campanario; Felipe Borges Fagundes

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Resumo

A fístula arteriovenosa (FAV) é uma sequela incomum de rotura espontânea de aneurisma arterial dentro do sistema venoso adjacente. Descrevemos, em um paciente de 74 anos, o tratamento endovascular de FAV ilíaca à direita por aneurisma de artéria ilíaca comum (AIC) roto associado a aneurisma de AIC distal à esquerda, em cuja cirurgia foram preservadas as artérias lombares e mesentérica inferior por necessidade de excluir simultaneamente as artérias hipogástricas. Foram demonstrados os fenômenos na dinâmica do balanço hídrico ocorridos em decorrência da interrupção da FAV. A evolução do paciente foi benigna, com normalização das graves alterações hemodinâmicas que apresentava e com desaparecimento dos sintomas respiratórios atribuídos à hipertensão arterial pulmonar.

Palavras-chave

fístula arteriovenosa, aneurisma ilíaco, veia ilíaca, artéria ilíaca, insuficiência cardíaca, aneurisma roto

Abstract

An arteriovenous fistula (AVF) is an uncommon sequela of spontaneous arterial aneurysm rupture into the adjacent venous system. We describe the case of a 74-year-old patient who underwent endovascular treatment of a right iliac AVF caused by a ruptured common iliac artery (CIA) aneurysm and a distal left CIA aneurysm. Surgery preserved the lumbar and inferior mesenteric arteries because of the need to simultaneously exclude the hypogastric arteries. Dynamic fluid balance phenomena provoked by closure of the AVF are described. The patient had a benign postoperative course with normalization of the severe hemodynamic changes presented prior to the intervention and resolution of respiratory symptoms attributed to pulmonary arterial hypertension.

Keywords

arteriovenous fistula; iliac aneurysm; iliac vein; iliac artery; heart failure; aneurysm; ruptured

References

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Submitted date:
03/09/2022

Accepted date:
06/30/2022

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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