Delayed Presentation of Ilio-Iliac Arteriovenous Fistula Following Laparoscopic Cholecystectomy Treated with Percutaneous Graft-Covered Stent Placement

Karigiannis, Michael; Pavlidis, George; Papageorgiou, George; Feretis, Christos; Stamou, Konstantinos M.; Vlachopoulos, Panayotis

doi:10.1089/lap.2005.15.411

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…Gregoric et al [6] first described a case of an aortocaval fistula presenting as acute renal failure. Since then, there have been only three cases [7-9] where the patient has presented with multiorgan failure. This is the second reported case of an endovascular repair of such a patient.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous endovascular repair of an iatrogenic carotid-jugular fistula and a large iliocaval fistula presenting with multiorgan failure: a case report

et al. 2012

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IntroductionIliocaval fistulas can complicate an iliac artery aneurysm. The clinical presentation is classically a triad of hypotension, a pulsatile mass and heart failure. In this instance, following presentation with multiorgan failure, management included the immediate use of an endovascular stent graft on discovery of the fistula.Case presentationA 62-year-old Caucasian man presented to our tertiary hospital for management of iatrogenic trauma due to the insertion of a central venous line into his right common carotid artery, causing transient ischemic attack. Our patient presented to a peripheral hospital with fever, nausea, vomiting, acute renal failure, acute hepatic dysfunction and congestive heart failure. A provisional diagnosis of sepsis of unknown origin was made. There was a 6.5 cm×6.5 cm right iliac artery aneurysm present on a non-contrast computed tomography scan. An unexpected intra-operative diagnosis of an iliocaval fistula was made following the successful angiographic removal of the central line to his right common carotid artery. Closure of the iliocaval fistula and repair of the iliac aneurysm using a three-piece endovascular aortic stent graft was then undertaken as part of the same procedure. This was an unexpected presentation of an iliocaval fistula.ConclusionOur case demonstrates that endovascular repair of a large iliac artery aneurysm associated with a caval fistula is safe and effective and can be performed at the time of the diagnostic angiography. The presentation of an iliocaval fistula in this case was unusual which made the diagnosis difficult and unexpected at the time of surgery. The benefit of immediate repair, despite hemodynamic instability during anesthesia, is clear. Our patient had two coronary angiograms through his right femoral artery decades ago. Unusual iatrogenic causes of iliocaval fistulas secondary to previous coronary angiograms with wire and/or catheter manipulation should be considered in patients such as ours.

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Section: Discussionmentioning

confidence: 99%

Simultaneous endovascular repair of an iatrogenic carotid-jugular fistula and a large iliocaval fistula presenting with multiorgan failure: a case report

et al. 2012

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“…However, in the case described, the patient was haemodynamically unstable, requiring inotropic support with renal impairment. It has been suggested that endovascular treatment of arteriovenous fistulas be reserved for elective presentations in stable patients, where there is sufficient time for careful planning of the procedure, and that surgery is more appropriate for patients presenting more acutely, given the lack of experience with endovascular management in this group of patients in the published reports to date 10 . It was felt that endovascular treatment had a high chance of failure in this study, as, unlike a fistula of iatrogenic cause (e.g.…”

Section: Discussionmentioning

confidence: 99%

Iliocaval arteriovenous fistula presenting with multiple organ failure

Lim

Stella

Dowling

et al. 2006

Australasian Radiology

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Iliac arteriovenous fistulas are an uncommon condition, which may be spontaneous or traumatic in nature. Such fistulas classically present with a triad of high-output cardiac failure, pulsatile abdominal mass with a bruit and unilateral leg ischaemia or venous congestion. We describe a case of an iliocaval fistula secondary to rupture of a common iliac artery aneurysm, with an unusual presentation of multiple organ failure, masquerading as sepsis. We describe the CT findings of iliocaval fistula, which was the means of diagnosis in this study.

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An acute abdominal syndrome reveals a postoperative ilio-iliac arteriovenous fistula: about one case

et al. 2014

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Delayed Presentation of Ilio-Iliac Arteriovenous Fistula Following Laparoscopic Cholecystectomy Treated with Percutaneous Graft-Covered Stent Placement

Cited by 4 publications

References 25 publications

Simultaneous endovascular repair of an iatrogenic carotid-jugular fistula and a large iliocaval fistula presenting with multiorgan failure: a case report

Simultaneous endovascular repair of an iatrogenic carotid-jugular fistula and a large iliocaval fistula presenting with multiorgan failure: a case report

Iliocaval arteriovenous fistula presenting with multiple organ failure

An acute abdominal syndrome reveals a postoperative ilio-iliac arteriovenous fistula: about one case

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