CardioVascular and Interventional Radiology

, Volume 33, Issue 4, pp 853–856 | Cite as

Endovascular Treatment of Ruptured Abdominal Aortic Aneurysm with Aortocaval Fistula

  • Giuseppe GuzzardiEmail author
  • Rita Fossaceca
  • Ignazio Divenuto
  • Antonello Musiani
  • Piero Brustia
  • Alessandro Carriero
Case Report


Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA). We report the endovascular repair of an AAA rupture into the inferior vena cava. A 78-year-old woman was admitted to our hospital for acute hypotension. She presented with a pulsatile abdominal mass and became rapidly anuric. Abdominal computed tomography (CT) showed an AAA rupture into the inferior vena cava. The features of the AAA made it suitable for endovascular repair. To prevent pulmonary embolism caused by the presence of sac thrombosis near the vena cava lumen, a temporary vena cava filter was deployed before the procedure. A bifurcated stent-graft was placed with the patient under local anaesthesia, and the AAA was successfully treated. A transient type II endoleak was detected on CT 3 days after endograft placement. At routine follow-up 6 and 12 months after the procedure, the patient was in good clinical condition, and the type II endoleak had sealed completely. Endovascular treatment offers an attractive therapeutic alternative to open repair in case of ACF; however, only small numbers of patients have been treated, and long-term follow-up interval is lacking.


Endovascular aneurysm repair Abdominal aortic aneurysm Aortocaval fistula 


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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2009

Authors and Affiliations

  • Giuseppe Guzzardi
    • 1
    Email author
  • Rita Fossaceca
    • 1
  • Ignazio Divenuto
    • 1
  • Antonello Musiani
    • 2
  • Piero Brustia
    • 2
  • Alessandro Carriero
    • 1
  1. 1.Institute of Interventional RadiologyMaggiore della Carità HospitalNovaraItaly
  2. 2.Division of Vascular SurgeryMaggiore della Carità HospitalNovaraItaly

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