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ludc webb

Nuno Dias

Associate professor

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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

Author

  • Magnus Sveinsson
  • Björn Sonesson
  • Timothy A. Resch
  • Nuno V. Dias
  • Jan Holst
  • Martin Malina

Summary, in English

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.

Publishing year

2016

Language

English

Pages

529-532

Publication/Series

Journal of Endovascular Therapy

Volume

23

Issue

3

Document type

Journal article

Publisher

International Society of Endovascular Specialists

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • Abdominal aortic aneurysm
  • Aortocaval fistula
  • Endoleak
  • Endovascular aneurysm repair
  • Ruptured aortic aneurysm
  • Spinal cord ischemia

Status

Published

ISBN/ISSN/Other

  • ISSN: 1526-6028