Blood pressure shifts resulting from a concealed arteriovenous fistula associated with an iliac aneurysm: a case report

JA Clinical Reports
Shintaro DoiHiromi Ito

Abstract

A solitary iliac aneurysm (SIA) is more uncommon than an abdominal aortic aneurysm. The aneurysm is located in the deep pelvis and is diagnosed when it reaches a large size with symptoms of compression around adjacent structures and organs or when it ruptures. A definite diagnosis of an arteriovenous fistula (AVF) associated with a SIA is difficult preoperatively because there might not be enough symptoms and time for diagnosis. Here, we present a patient with asymptomatic rupture of SIA into the common iliac vein with characteristic blood pressure shifts. A 41-year-old man with a huge SIA underwent aortobifemoral graft replacement. Preoperatively, his blood pressure showed characteristic shifts for one or two heartbeats out of five beats, indicating that an AVF was present and that the shunt was about to having a high flow. During surgery, an AVF associated with the SIA was found to be concealed owing to compression from the huge iliac artery aneurysm, and the shunt showed a high flow, resulting in shock during the surgery. No complications were noted after aortobifemoral graft replacement. Postoperatively, we noted an enhanced paravertebral vein on computed tomography (CT), which indicated the presence of an AVF. Definite dia...Continue Reading

References

Jul 31, 1998·Journal of Vascular Surgery·W C KrupskiT A Whitehill
Jun 3, 2008·Journal of Vascular Surgery·Ying HuangThomas C Bower
Jun 29, 2015·International Journal of Surgery Case Reports·Makoto IijimaYoshimitsu Ishibashi

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