Aortocaval fistula formation due to ruptured abdominal aortic aneurysms: a 12-year series

Vascular and Endovascular Surgery
Ioannis KotsikorisEfstratios Maltezos

Abstract

This study reports on the frequency and management of aortocaval fistulas (ACFs) in our department between 1998 and 2009. Overall frequency of ACFs among ruptured abdominal aortic aneurysms was 5.5%. Patients presented with low back pain (92.8%), abdominal tenderness (78.6%), hemorrhagic shock (28.6%), congestive heart failure (21.4%), dyspnea (42.8%), and palpitations (57.1%). The most reliable clinical sign was the presence of palpable pulsating abdominal mass (92.8%). Other clinical findings included increased central venous pressure (21.4%), lower extremity edema (71.4%), hematuria (21.4%), and scrotal edema (14.3%). Diagnosis was established preoperatively in 85.7% and intraoperatively in 14.3% of cases. Surgery was successful in promptly improving clinical signs and symptoms. Mortality rate was 7.1%. After a mean follow-up of 18.5 months, all surviving patients remained free from complications. In conclusion, ACFs represent a life-threatening emergency for vascular surgeons but can be successfully managed.

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Citations

Nov 26, 2015·Annals of Vascular Surgery·Kristine Clodfelter OrionJames H Black
Jan 5, 2014·Annals of Vascular Diseases·Tanop SrisuwanKittipan Rerkasem
Jun 8, 2021·Jornal Vascular Brasileiro·Carolina de OliveiraAna Terezinha Guillaumon
Jul 16, 2021·Vascular and Endovascular Surgery·Lei ZhangXin Li
Jul 31, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Aishwarya GulatiMaansi Parekh

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