Aneurisma roto de aorta abdominal y fístula aortocava: un hallazgo altamente letal
Ruptured abdominal aortic aneurysm and aortocaval fistula: a highly lethal find
Walter Mario Ángel Jaramillo; Marby Sharyne Forero Gaviria; Romario Chanci Drago; Natalia Guzmán Arango; Natalia Barrera Cuesta; Andrés Gilberto Giraldo Echeverri; Verónica Lucía Malabet Mejía
Resumen
Palabras clave
Abstract
Within the spectrum of abdominal aortic aneurysm, various complications can arise, including the development of an arteriovenous fistula connecting this major vessel to the infrarenal inferior vena cava. This report presents the case of a 70-year-old man with sudden, intense abdominal pain and syncope, found intraoperatively to have an aortocaval fistula due to a ruptured abdominal aortic aneurysm. The patient underwent emergency care, including fistula closure and placement of a Dacron aortobifemoral graft. Aortocaval fistula is a rare complication of aortic aneurysmal disease, with clinical manifestations varying depending on disease progression, leading to high morbidity and mortality both before and after surgical or interventional treatment.
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References
1 Dakis K, Nana P, Kouvelos G, et al. Treatment of aortocaval fistula secondary to abdominal aortic aneurysm: a systematic review. Ann Vasc Surg. 2023;90:204-17.
2 Syme J. Case of spontaneous varicose aneurism. Edinb Med Surg J. 1831;36(108):104-5. PMid:30329946.
3 Zúñiga G, Ramón Rodríguez J, Cáceres P. Fístula aortocava como complicación de aneurisma aórtico abdominal. Rev Chil Cir. 2011;63(6):623-6.
4 Akwei S, Altaf N, Tennant W, MacSweeney S, Braithwaite B. Emergency endovascular repair of aortocaval fistula: a single center experience. Vasc Endovascular Surg. 2011;45(5):442-6.
5 Moore WS, Lawrence PF, Oderich GS. Fístula aortocava: cirugía vascular y endovascular. New York: Elsevier; 2019.
6 Dakis K, Nana P, Kouvelos G, et al. Treatment of aortocaval fistula secondary to abdominal aortic aneurysm: a systematic review. Ann Vasc Surg. 2023;90:204-17.
7 Umscheid T, Stelter WJ. Endovascular treatment of an aortic aneurysm ruptured into the inferior vena cava. J Endovasc Ther. 2000;7(1):31-5.
8 Silveira PG, Cunha JRF, Lima GBB, Franklin RN, Bortoluzzi CT, Galego GN. Endovascular treatment of ruptured abdominal aortic aneurysm with aortocaval fistula based on aortic and inferior vena cava stent-graft placement. Ann Vasc Surg. 2014;28(8):1933.e1.
9 Wang Y, Yu W, Li Y, Wang H. Emergent endovascular repair of challenging aortocaval fistula with hostile anatomy. Vasc Endovascular Surg. 2017;51(5):255-60.
10 Beveridge CJ, Pleass HC, Chamberlain J, Wyatt MG, Rose JD. Aortoiliac aneurysm with arteriocaval fistula treated by a bifurcated endovascular stent-graft. Cardiovasc Intervent Radiol. 1998;21(3):244-6.
11 Maeda H, Umezawa H, Goshima M, et al. Surgery for ruptured abdominal aortic aneurysm with an aortocaval and iliac vein fistula. Surg Today. 2007;37(6):445-8.
12 Dabbouseh NM, Mason PJ, Patel PJ, Rossi PJ. Endovascular repair of delayed traumatic aortocaval fistula. J Vasc Surg Cases Innov Tech. 2019;5(4):467-71.
13 Orion KC, Beaulieu RJ, Black JH 3rd. Aortocaval Fistula: is endovascular repair the preferred solution? Ann Vasc Surg. 2016;31:221-8.
14 Brightwell RE, Pegna V, Boyne N. Aortocaval fistula: current management strategies. ANZ J Surg. 2013;83(1-2):31-5.
15 Patelis N, Giagkos GC, Maltezos K, Klonaris C. Aortocaval fistula: an unusual complication of ruptured abdominal aortic aneurysm. BMJ Case Rep. 2018;2018:477-80.
16 Lau LL, O’Reilly MJ, Johnston LC, Lee B. Endovascular stent-graft repair of primary aortocaval fistula with an abdo- minal aortoiliac aneurysm. J Vasc Surg. 2001;33(2):425-8.
17 Mitchell ME, McDaniel HB, Rushton FW Jr. Endovascular repair of a chronic aortocaval fistula using a thoracic aortic endoprosthesis. Ann Vasc Surg. 2009;23(1):150-2.
18 Rojas Borda F, Patiño Tinoco P, Martinez V, Contreras M. Fístula aortocava en un devastador aneurisma abdominal: reporte de caso y revisión de la literatura. Rev Med. 2021;29(1):77-84.
19 Sultan S, Zaki M, Alawy M, ElKassaby M. Aortic and inferior vena cava bifurcated stent graft application in the endovascular management of a ruptured abdominal aortic aneurysm with an aortocaval fistula. J Vasc Surg. 2014;60(6):1665-6.
20 Esmat HA, Naseri MW. Endovascular management of aortocaval fistula complicating abdominal aortic aneurysm presenting as an acute renal failure. Ann Med Surg. 2021;62:477-80.
Submitted date:
10/07/2024
Accepted date:
02/08/2025