Endoprosthetic repair of abdominal aortic aneurysm complicated by rupture into the vena cava inferior with formation of an aortocaval fistula

Ignatyev I.M., Volodyukhin M.Yu., Krepkogorsky N.V., Zanochkin A.V.

Interregional Clinical Diagnostic Centre, Kazan State Medical University, Kazan, Russia

The article deals with is a case report of successful endovascular treatment of a patient with a saccular aneurysm of the infrarenal portion of the abdominal aorta complicated by its rupture into the inferior vena cava with formation of an aortocaval fistula.

The patient underwent endoprosthetic repair of the abdominal aorta with the unilateral stent graft Endurant II 32×14-117 mm (Medtronic) and cross-over femorofemoral bypass.

The postoperative period was complicated by acute cardiac insufficiency and pulmonary oedema. After the appropriate intensive therapy lung oedema subsided, the events of cardiac insufficiency disappeared, and haemodynamics stabilized. According to the findings of the control multispiral computed tomography, the fistula does not function, there are no signs of the stent graft’s dislocation or endoleak, with the cross-over femorofemoral bypass patent. The patient was discharged in a satisfactory condition.

KEY WORDS: aneurismal rupture of abdominal aortic aneurysm rupture, aortocaval fistula, endoprosthetic repair, acute cardiac insufficiency, lung pulmonary oedema.

P. 153

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