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Contrast-Enhanced Ultrasound in Detection and Follow-Up of an Infrarenal Abdominal Aortic Aneurysm with Aorto-Caval Fistula and Endovascular Treatment

CardioVascular and Interventional Radiology volume 30, pages 480–484 (2007)Cite this article

Abstract

An aorto-caval fistula is a rare complication of a symptomatic or ruptured infrarenal aortic aneurysm having a frequency of 3–6%. Patients typically present with clinical signs of diffuse abdominal pain associated with increasing venous congestion and tachycardia, rapid cardiopulmonary decompensation with acute dyspnea, and an audible machinerylike bruit. Perioperative mortality is high, ranging from 20% to 60%. We report a case of an endovascular aortic repair in a patient with a symptomatic infrarenal aortic aneurysm and an aorto-caval fistula. Contrast-enhanced ultrasound seems to be a promising new diagnostic option for the diagnosis and preoperative treatment planning for patients with abdominal aortic aneurysms with rupture into the inferior vena cava. It is in addition to computed tomography angiography. It might allow a more rapid and noninvasive diagnosis, especially for patients in intensive care because of its bedside availability. Because the examination is dynamic, additional information about blood flow between the aorta and inferior cava vein can be evaluated.

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Affiliations

  1. Department of Clinical Radiology, University of Munich–Grosshadern Campus, Munich, Germany

    D.-A. Clevert, P. Flach, T. Strautz, A. Horng & M. Reiser

  2. Department of Surgery, Klinikum Grosshadern University of Munich, Munich, Germany

    M. Stickel & K. W. Jauch

Authors
  1. D.-A. Clevert
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  2. M. Stickel
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  3. P. Flach
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  4. T. Strautz
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  5. A. Horng
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  6. K. W. Jauch
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  7. M. Reiser
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Correspondence to D.-A. Clevert.

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Clevert, DA., Stickel, M., Flach, P. et al. Contrast-Enhanced Ultrasound in Detection and Follow-Up of an Infrarenal Abdominal Aortic Aneurysm with Aorto-Caval Fistula and Endovascular Treatment. Cardiovasc Intervent Radiol 30, 480–484 (2007). https://doi.org/10.1007/s00270-006-0143-3

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  • DOI: https://doi.org/10.1007/s00270-006-0143-3

Keywords

  • Aorto-caval fistula
  • Abdominal aortic aneurysm
  • Contrast-enhanced ultrasound
  • Endoleak