Background: Aortocaval fistula (ACF) secondary to an abdominal aortic aneurysm is a rare complication, inadvertently caused by a rupture into the inferior vena cava. Different treatment modalities have been applied toward the repair of such lesions, including open surgical and endovascular repair. The aim of this study was to report on ACF treatment and to analyze its early and mid-term outcomes.
Methods: A systematic search of the English medical literature published between 2000 and 2022 was undertaken, using PubMed, SCOPUS, and CENTRAL databases as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. A study protocol was registered in PROSPERO (CRD42022329058). Studies reporting on primary ACF outcomes following open surgical or endovascular repair were included. The ROBINS-I tool was applied for risk of bias assessment. Outcomes included technical success, 30-day and mid-term survival, endoleak following endovascular repair, and reintervention rates.
Results: In total, 110 case studies, incorporating 196 patients (mean age; 66.2 years, males 96%) were included. Open surgical repair was applied in 78% (153/196). From the available data, technical success rate for each modality was 99% (152/153) and 100% (43/43), respectively. Open and endovascular repair demonstrated 87.5% (126/144) and 97.6% (42/43) 30-day survival, respectively, while mid-term survival was 86% (74/86) and 95.2% (20/21), respectively (medial follow-up: 14 months [1-54 months]). Endoleaks were reported in 19 endovascular cases (39.5%). Type II endoleak was the most frequent with a rate at 32.5% (14/43). Reintervention rates were 2.5% (4/151) and 35.7% (15/42) for open and endovascular repair, respectively.
Conclusions: Only few case studies were published on the treatment of this rare condition, while almost all invasive procedures were performed in males. Management of ACF repair with both open and endovascular approach was associated with excellent technical success rate and acceptable early and mid-term survival outcomes. Reintervention remained an issue for patients who were managed endovascularly.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.avsg.2022.11.008 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparison of short-and long-term outcomes between endovascular and open repair for descending thoracic aortic aneurysm: a systematic review and meta-analysis.
Int J Surg
January 2025
Department of Cardiovascular Surgery, Nanchong Central Hospital, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong Hospital of Beijing Anzhen Hospital Capital Medical University, Nanchong, China.
Objective: This systematic review and meta-analysis aimed to evaluate and compare the efficacy of endovascular versus open repair for the treatment of patients with descending thoracic aortic aneurysm (DTAA).
Methods: A systematic search of the PubMed, Embase, and Cochrane Library databases for relevant studies was performed. Outcome data, including postoperative mortality and morbidity, operative details, all-cause survival, freedom from aortic-related survival and freedom from aortic-related re-intervention, were independently extracted by two authors in a standardized way.
Simple vs Complex Aortic Arch Repair in Acute Type A Aortic Dissection.
J Am Coll Surg
January 2025
University of Florida Health, Division of Cardiovascular Surgery, Department of Surgery, Gainesville, Florida USA.
Background: The purpose of this study is to evaluate the clinical outcomes of patients undergoing a simpler (hemiarch) vs complex (zone 2 arch) aortic repair for acute type A aortic dissection (TAAD).
Methods: Adults (≥18 years) who underwent hemiarch or zone 2 arch repair for acute, hyperacute, or acute on chronic TAAD at a single institution between January 2018 and April 2024 were reviewed. Disabling stroke was defined as modified Rankin scale ≥4.
Abscess and aneurysm: A case of tuberculous abscess causing an aortic pseudo-aneurysm.
Radiol Case Rep
March 2025
Maimonides Medical Center, Brooklyn, NY, USA.
Thoracic aortic pseudoaneurysms are a rare but serious complication of infectious processes, often resulting from mycotic (infectious) aneurysms, occurring when the vessel wall is compromised by an infection, leading to the formation of a pseudoaneurysm [1]. Mycotic aneurysms typically result from bacteremia or fungemia, with common sources being infective endocarditis or other systemic infections. Tuberculosis, though a common infectious disease worldwide, is an unusual cause of aortic pseudoaneurysm formation.
View Article and Find Full Text PDFRepair of a type II thoracoabdominal aortic aneurysm with three equal-sized renal arteries and bilateral common iliac aneurysms using a completely percutaneous transfemoral approach.
J Vasc Surg Cases Innov Tech
April 2025
Division of Vascular and Endovascular Surgery, University of Massachusetts Chan Medical School, Worcester, MA.
Transaxillary endovascular aortic aneurysm repair using a reverse mounted Gore Excluder endograft for a patient with abdominal aortic aneurysm and severe iliofemoral occlusive disease.
J Vasc Surg Cases Innov Tech
April 2025
Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Adverse iliofemoral anatomy represents a unique challenge for endovascular aortic aneurysm repair (EVAR). This report describes a transaxillary EVAR in a patient with severe iliofemoral occlusive disease and an infrarenal aortic aneurysm. A reversely mounted Gore Excluder graft was advanced and deployed in the infrarenal aorta using the left axillary artery.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!