Aortocaval and iliac arteriovenous fistulas: Recognition and treatment

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Presentation transcript:

Aortocaval and iliac arteriovenous fistulas: Recognition and treatment David C. Brewster, MD, Richard P. Cambria, MD, Ashby C. Moncure, MD, R.Clement Darling, MD, Glenn M. LaMuraglia, MD, Stuart C. Geller, MD, William M. Abbott, MD Journal of Vascular Surgery Volume 13, Issue 2, Pages 253-265 (February 1991) DOI: 10.1016/0741-5214(91)90218-J Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Fistula location in 20 patients with an aortic or iliac AV fistula. Journal of Vascular Surgery 1991 13, 253-265DOI: (10.1016/0741-5214(91)90218-J) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Left iliac AV fistula with large associated false aneurysm detected 8 years after laminectomy and disk removal (case 19). Journal of Vascular Surgery 1991 13, 253-265DOI: (10.1016/0741-5214(91)90218-J) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Aortocaval fistula (large curved arrow) and opacified inferior vena cava (outlined by smaller arrows) demonstrated by aortogram obtained to evaluate gross hematuria and persistent unexplained hypotension, after emergency laparotomy failed to reveal anticipated rupture of a large aortic aneurysm (case 6). B, Pelvis views, revealing opacification of lower aspect of aneurysm and iliac arteries, as well as extensively dilated pelvic venous system. Journal of Vascular Surgery 1991 13, 253-265DOI: (10.1016/0741-5214(91)90218-J) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Preoperative aortogram in patient (case 9) with large aneurysm and renal insufficiency (blood urea nitrogen 60, creatinine 4.4), performed to evaluate suspected renal artery disease. Unexpected aortocaval fistula was demonstrated (large curved arrow) with opacified inferior vena cava compressed and deviated laterally (smaller arrows). Journal of Vascular Surgery 1991 13, 253-265DOI: (10.1016/0741-5214(91)90218-J) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Ruptured right iliac aneurysm and AV fistula, documented by angiography after lengthy medical workup for massive lower extremity edema and suspected cardiac ventricular septal defect (case 12). Journal of Vascular Surgery 1991 13, 253-265DOI: (10.1016/0741-5214(91)90218-J) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions