MDCT and virtual angioscopy in spontaneous aortocaval fistula

Abstract

Aortocaval fistula is a rare, less than 1%, but life threatening complication, of abdominal aortic aneurysm. Mortality is high but prompt recognition of the fistula can reduce mortality rate. The multidetector row CT (MDCT) findings in a 69-year-old patient with a complex medical history characterized by previous episodes of myocardial ischemia, is reported. MDCT shows an early homogeneous enhancement of the inferior vena cava, slightly dilated at the liver level and markedly narrowed above the renal vein due to aneurysm compression. The patient underwent to emergency laparotomy but died during surgery for cardiac arrest. MDCT allows a prompt recognition of the fistula and different computerized reconstruction techniques as maximum intensity projection (MIP), multiplanar reformatting (MPR) and virtual angioscopy (VA) added imaging information for surgery.

Spontaneous ilio-iliac arteriovenous fistula: A rare complication of aorto-iliac aneurysm

“…Cheung et al were the first to describe the use of dynamic CT with intravenous iodinated contrast agents injection to diagnose an iliac arteriovenous fistula [12] . Multi-detector CT has become the gold standard in imaging, permitting a rapid and highly accurate preoperative diagnosis to guide therapeutic management of AVF, particularly in cases with atypical clinical symptoms [16] , [17] . CT scan provides all the information required for therapeutic management, including aneurysm size, collar, longitudinal extension to the celiac trunk, and to the renal and iliac arteries, iliofemoral network condition, presence of arterial or venous anatomical variants, morphology of the aneurysmal lesion (wall, endoaneurysmal thrombus), and the periaurysmal environment.…”

The Successful Treatment of an Ilio-Iliac Fistula and Aneurysms Affecting the Abdominal Aortic and Iliac Arteries via Endovascular Stent Graft Repair

“…1,2 Multidetector row CT (MDCT) is a valuable imaging modality for obtaining a precise and prompt diagnosis of AVF, especially in cases involving atypical clinical symptoms. 5,6 Furthermore, different MDCT-based computerized reconstruction techniques, such as maximum intensity projection, volume rendering, and virtual angioscopy, allow the accurate localization and measurement of AVF. 5 Figure 1.…”

Cause of a rare acute renal insufficiency: Rupture aortocaval fistula

“…CT angiography and magnetic resonance (MR) angiography are the options. [3][4][5] Because of the absence of MR imaging machine in our institution, we used CT angiography.…”