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Aneurysm shrinkage is compatible with massive endoleak in the presence of an aortocaval fistula : Potential therapeutic implications for endoleaks and spinal cord ischemia

Sveinsson, Magnus LU ; Sonesson, Björn LU ; Resch, Timothy A. LU ; Dias, Nuno V. LU ; Holst, Jan LU and Malina, Martin LU (2016) In Journal of Endovascular Therapy 23(3). p.529-532
Abstract

Purpose: To present a patient with ruptured abdominal aortic aneurysm (AAA) and aortocaval fistula who was successfully treated with endovascular aneurysm repair in spite of developing a massive endoleak. Case Report: A 70-year-old man with ruptured AAA and aortocaval fistula was treated with endovascular aneurysm repair (EVAR). During 8 years of followup, he had massive perfusion of the aneurysm sac by retrograde flow from the inferior mesenteric artery into the caval vein through the aortocaval fistula. The aneurysm diameter decreased continuously in spite of the type II endoleak. This observation illustrates the mechanisms of sac expansion and may have therapeutic implications for complicated type II endoleaks and prevention of... (More)

Purpose: To present a patient with ruptured abdominal aortic aneurysm (AAA) and aortocaval fistula who was successfully treated with endovascular aneurysm repair in spite of developing a massive endoleak. Case Report: A 70-year-old man with ruptured AAA and aortocaval fistula was treated with endovascular aneurysm repair (EVAR). During 8 years of followup, he had massive perfusion of the aneurysm sac by retrograde flow from the inferior mesenteric artery into the caval vein through the aortocaval fistula. The aneurysm diameter decreased continuously in spite of the type II endoleak. This observation illustrates the mechanisms of sac expansion and may have therapeutic implications for complicated type II endoleaks and prevention of spinal cord ischemia in thoracic stent-grafting. Conclusion: EVAR can be applied in this rare setting because the ensuing high-flow endoleak is associated with sac shrinkage owing to depressurization by the caval shunt.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abdominal aortic aneurysm, Aortocaval fistula, Endoleak, Endovascular aneurysm repair, Ruptured aortic aneurysm, Spinal cord ischemia
in
Journal of Endovascular Therapy
volume
23
issue
3
pages
4 pages
publisher
International Society of Endovascular Specialists
external identifiers
  • scopus:85012993546
ISSN
1526-6028
DOI
10.1177/1526602816638834
language
English
LU publication?
no
id
087a457d-05a7-4216-bbc9-6df4a3f94241
date added to LUP
2017-03-03 13:06:56
date last changed
2017-03-04 03:00:02
@article{087a457d-05a7-4216-bbc9-6df4a3f94241,
  abstract     = {<p>Purpose: To present a patient with ruptured abdominal aortic aneurysm (AAA) and aortocaval fistula who was successfully treated with endovascular aneurysm repair in spite of developing a massive endoleak. Case Report: A 70-year-old man with ruptured AAA and aortocaval fistula was treated with endovascular aneurysm repair (EVAR). During 8 years of followup, he had massive perfusion of the aneurysm sac by retrograde flow from the inferior mesenteric artery into the caval vein through the aortocaval fistula. The aneurysm diameter decreased continuously in spite of the type II endoleak. This observation illustrates the mechanisms of sac expansion and may have therapeutic implications for complicated type II endoleaks and prevention of spinal cord ischemia in thoracic stent-grafting. Conclusion: EVAR can be applied in this rare setting because the ensuing high-flow endoleak is associated with sac shrinkage owing to depressurization by the caval shunt.</p>},
  author       = {Sveinsson, Magnus and Sonesson, Björn and Resch, Timothy A. and Dias, Nuno V. and Holst, Jan and Malina, Martin},
  issn         = {1526-6028},
  keyword      = {Abdominal aortic aneurysm,Aortocaval fistula,Endoleak,Endovascular aneurysm repair,Ruptured aortic aneurysm,Spinal cord ischemia},
  language     = {eng},
  number       = {3},
  pages        = {529--532},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Therapy},
  title        = {Aneurysm shrinkage is compatible with massive endoleak in the presence of an aortocaval fistula : Potential therapeutic implications for endoleaks and spinal cord ischemia},
  url          = {http://dx.doi.org/10.1177/1526602816638834},
  volume       = {23},
  year         = {2016},
}