Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysms (AAA), involving less than 1% of all AAA and is associated with high morbidity and mortality; it is even more uncommon, following endovascular aneurysm repair. The clinical presentation can be variable and making the diagnosis can be difficult. It can present with symptoms and signs of an abdominal emergency or systemic hypoperfusion. The traditional method of repair has been open surgery, which is associated with a high mortality rate. Endovascular repair has become more common, but results are difficult to interpret due to the low incidence of ACF. A high index of suspicion is imperative to avoid delay in diagnosis and care.
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http://dx.doi.org/10.1055/s-0038-1669455 | DOI Listing |
Cardiovasc Res
January 2025
Department of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Vasc Specialist Int
December 2024
Department of Vascular and Endovascular Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Aortocaval fistulas, typically linked to aortoiliac aneurysms, are rare vascular conditions. Currently, endovascular therapy is preferred treatment approach. However, endovascular therapy requires frequent and extended follow-up evaluations.
View Article and Find Full Text PDFJ Endovasc Ther
November 2024
Department of Interventional Radiology, University Hospital Leuven, Leuven, Belgium.
Purpose: We described an alternative access for thoracic endovascular aortic repair (TEVAR) deployment using a transjugular intrahepatic portosystemic shunt (TIPS) needle for gaining transcaval access to the abdominal aorta.
Case Report: A 63-year-old man presented with a penetrating atherosclerotic ulcer in the descending aorta. Traditional transfemoral and transaxillary access were not possible.
Vasc Endovascular Surg
November 2024
Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA.
Primary aortocaval fistulas (ACF) are a rare complication of abdominal aortic aneurysm (AAA), for which treatment options encompass both endovascular and open surgical intervention. To report a rare presentation of primary aortocaval fistula. Case Report.
View Article and Find Full Text PDFArterioscler Thromb Vasc Biol
December 2024
Vascular Biology and Therapeutics Program (W.Z., L.G., H.B., Z.L., R.T., J.L., Y.O., C.T., A.Y., B.Y., K.A.M., J.G., G.T., A.D.), Yale School of Medicine, New Haven, CT.
Background: Arteriovenous fistulae (AVF) are the preferred vascular access for hemodialysis in patients with end-stage kidney disease. Chronic kidney disease (CKD) is associated with endothelial injury, impaired AVF maturation, and reduced patency, as well as utilization. Because CKD is characterized by multiple pathophysiological processes that induce endothelial-to-mesenchymal transition (EndMT), we hypothesized that CKD promotes EndMT during venous remodeling and that disruption of endothelial TGF (transforming growth factor)-β signaling inhibits EndMT to prevent AVF failure even in the end-stage kidney disease environment.
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