2017 Volume 26 Issue 3 Pages 157-160
Ruptured aortoiliac aneurysm to vena cava is a rare, but life-threatening disease requiring immediate treatment. Treatment is usually performed by open surgery with direct closure of arteriovenous fistula and graft replacement of the aortoiliac lesion. As high morbidity and mortality with open repair, endovascular treatment has been motivated and reported in certain patients recently. A 70-year-old man was admitted to our department with progressive heart failure and contrast enhanced CT scan revealed to right isolated common iliac artery aneurysm associated with an iliocaval fistula. Endovascular stent-graft repair with coil embolization of right internal iliac artery was successfully performed to achieve exclusion of the fistula and restoration of normal hemodynamics. Postoperative CT scan showed a minor AV communication due to endoleak, which was terminated by the additional radiological intervention. Postoperative residual shunt due to endoleak is significant; therefore, complete graft sealing and complete coil embolization of branched arteries are absolutely essential in endovascular treatment for AV fistula in aortoiliac aneurysm.
