Aortocaval Fistula: A Rare Cause of Venous Hypertension and Acute Renal Failure

Abstract

Spontaneous rupture of abdominal aortic aneurysm into the inferior vena cava is rare and is associated with high mortality and morbidity. The clinical presentation can be variable and thus the diagnosis can be difficult. It can present with symptoms and signs of an abdominal emergency, venous hypertension, or systemic hypoperfusion. The traditional method of repair has been open surgery which is associated with high rate of complications. We report a case of aortocaval fistula (ACF) presenting with acute renal failure and heart failure, which was treated successfully with a novel, endovascular approach.

Tratamento endovascular de aneurisma de aorta abdominal com fístula aorto-cava utilizando oclusor vascular concomitante a endoprótese bifurcada: relato de caso

“…Other reports only describe conventional treatment of the aneurysm with an endograft, without use of filters, achieving successful occlusion of the aortocaval fistula without reporting paradoxical embolism. [15][16][17] In view of the size of the aneurysm exerting pressure on the wall of the vena cava (which could make placement and removal of the temporary filter difficult) and since the occluder was available, we decided not to employ a filter. When occluding the fistula canal prior to introduction of the endograft, we therefore manipulated the lumen of the aneurysm as little as possible to avoid displacement of thrombi, and consequently PPE.…”

A Case Report of Delayed Diagnosed Chronic Aortocaval Fistula: A Rare Complication of Penetrating Trauma to the Abdomen

“…Hemodynamic effects of ACP when combined with patient age and other comorbidities impose a life-threatening condition for many patients. [ 3 ] Symptoms and signs of acute abdomen may present as venous hypertension and/or systemic hypoperfusion. [ 3 ] Open surgery is the conventional method of repair in these cases; however, surgical complication risk rates are very high.…”

“…[ 3 ] Symptoms and signs of acute abdomen may present as venous hypertension and/or systemic hypoperfusion. [ 3 ] Open surgery is the conventional method of repair in these cases; however, surgical complication risk rates are very high. [ 3 ] Percutaneous endovascular treatment is the best treatment option in these patients.…”

“…[ 3 ] Open surgery is the conventional method of repair in these cases; however, surgical complication risk rates are very high. [ 3 ] Percutaneous endovascular treatment is the best treatment option in these patients. [ 1 ]…”

Superficial thrombophlebitis of the abdominal veins as a complication of ruptured aortocaval fistula surgery

“…Clinical features of chronic fistuale are predominately due to high venous return, which often results in high‐output cardiac failure. The venous hypertension may result in bilateral oedema, haematuria and acute kidney injury …”