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Benbrahim FZ, Ankri M, Fariyou A, El Aoufir O, Laamrani FZ, Laila J. Spontaneous ilio-iliac arteriovenous fistula: A rare complication of aorto-iliac aneurysm. Radiol Case Rep 2024; 19:2996-3000. [PMID: 38737172 PMCID: PMC11087909 DOI: 10.1016/j.radcr.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 05/14/2024] Open
Abstract
Ilio-iliac arteriovenous fistula is an unusual complication of aorto-iliac aneurysms that can occur spontaneously, traumatically or iatrogenically. The typical clinical presentation includes the characteristic triad of high-output heart failure, a pulsatile abdominal mass with unilateral limb ischemia, or signs of venous congestion. We describe a rare case of spontaneous rupture of an aortoiliac aneurysm into the left common iliac vein of a 65-year-old man, easily diagnosed by angiography. We highlight here the angiographic findings of the ilio-iliac fistula, which was the means of diagnosis in this presentation, especially in patients with atypical clinical features at the outset, and we report the difficulties in choosing the optimal vascular approach.
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Affiliation(s)
- Fatima Zohra Benbrahim
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Majda Ankri
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Asmae Fariyou
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Omar El Aoufir
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Fatima Zahra Laamrani
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Jroundi Laila
- Department of Emergency Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
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Sueyoshi E, Iwano Y, Oka T, Nishimura T, Honda T, Kawaguchi Y, Koike H, Nagayama H, Sakamoto I, Uetani M. The Successful Treatment of an Ilio-Iliac Fistula and Aneurysms Affecting the Abdominal Aortic and Iliac Arteries via Endovascular Stent Graft Repair. Vasc Endovascular Surg 2020; 55:91-94. [PMID: 32875955 DOI: 10.1177/1538574420953933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Spontaneous ilio-iliac arteriovenous fistula (AVF) associated with aneurysms affecting the abdominal aortic and iliac arteries is a rare condition. The classical clinical symptoms of ilio-iliac AVF include high-output heart failure, abdominal pain, abdominal bruits and thrills, a pulsatile abdominal mass, and venous congestion symptoms (leg edema and hematuria). The prompt repair of AVF is necessary to restore the patient's hemodynamics. We report a case in which a patient with aneurysms affecting the abdominal aortic and iliac arteries and an ilio-iliac AVF presented with high-output heart failure and leg ischemia and was successfully treated via endovascular stent graft repair.
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Affiliation(s)
- Eijun Sueyoshi
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan.,Department of Radiological Science, 200674Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yusuke Iwano
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Taiga Oka
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Takamasa Nishimura
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Takahide Honda
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Yutaro Kawaguchi
- Department of Cardiovascular Surgery, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Hirofumi Koike
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Hiroki Nagayama
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Ichiro Sakamoto
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan.,Department of Radiological Science, 200674Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan.,Department of Radiological Science, 200674Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Simsek E, Caliskan A, Tutun U, Sahin S. Cause of a rare acute renal insufficiency: Rupture aortocaval fistula. Vascular 2013; 22:290-2. [DOI: 10.1177/1708538113493418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Abdominal aortic aneurysms can be complicated by some conditions and aortocaval fistula is one of them. Aortocaval fistula is an unusual entity. Case Report A male patient was admitted to the hospital for abdominal pain and leg oedema of three days duration. In addition, severe anuria was also noted. We determined a fistula from the right lateral wall of aneurysm to the distal of vena cava inferior. The aortocaval fistula was closed with pledged-reinforced 4/0 polypropylene suture in the aneurysmal wall. At the postoperative 10th day, he was discharged with normal renal function. Discussion After a long-term untreated fistula, right-sided heart failure, acute renal and hepatic insufficiency, deep vein thrombosis and pulmonary thrombo-embolism can be seen in these patients. Increased venous pressure should be the reason for decreased arterial flow results in renal insufficiency. Emergency intervention in these patients saves the patient’s life as well as prevents irreversible organ failure.
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Affiliation(s)
- Erdal Simsek
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Aytac Caliskan
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Ufuk Tutun
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Serpil Sahin
- Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
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Bhatia M, Platon A, Khabiri E, Becker C, Poletti PA. Contrast enhanced ultrasonography versus MR angiography in aortocaval fistula: case report. ACTA ACUST UNITED AC 2009; 35:376-80. [DOI: 10.1007/s00261-009-9507-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 02/19/2009] [Indexed: 10/21/2022]
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Goto T, Enmoto T, Akimoto K. Diagnosis of an ilio-iliac arteriovenous fistula by multidetector row computed tomography and surgical repair. Interact Cardiovasc Thorac Surg 2009; 8:387-9. [DOI: 10.1510/icvts.2008.198945] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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