TY - JOUR
T1 - The management of primary aortocaval and ilio-iliac arteriovenous fistulae
AU - Gloviczki, Peter
AU - Baker, William H.
AU - Kalman, Peter G.
AU - Han, David
PY - 1999
Y1 - 1999
N2 - The diagnosis and treatment of large abdominal arteriovenous fistulae continue to be challenging, since presentation is frequently atypical and the patients are usually severely ill. Clinical suspicion of rupture of an aortic or iliac aneurysm into the iliac vein or vena cava is confirmed in a hemodynamically stable patient by computed tomography, performed with intravenous contrast. Expeditious open surgical repair is recommended. Intraoperative techniques are directed to avoid embolization of aneurysmal debris through the fistula, to decrease blood loss using rapid cell saver, and the use of Swan Ganz catheter to optimize major hemodynamic alterations. Although complications are frequent, clinical outcome is more favorable than retroperitoneal or intraperitoneal rupture of an aortic aneurysm. Endovascular repair of primary aortocaval fistula remains a task for the future.
AB - The diagnosis and treatment of large abdominal arteriovenous fistulae continue to be challenging, since presentation is frequently atypical and the patients are usually severely ill. Clinical suspicion of rupture of an aortic or iliac aneurysm into the iliac vein or vena cava is confirmed in a hemodynamically stable patient by computed tomography, performed with intravenous contrast. Expeditious open surgical repair is recommended. Intraoperative techniques are directed to avoid embolization of aneurysmal debris through the fistula, to decrease blood loss using rapid cell saver, and the use of Swan Ganz catheter to optimize major hemodynamic alterations. Although complications are frequent, clinical outcome is more favorable than retroperitoneal or intraperitoneal rupture of an aortic aneurysm. Endovascular repair of primary aortocaval fistula remains a task for the future.
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U2 - 10.1177/153100359901200120
DO - 10.1177/153100359901200120
M3 - Article
AN - SCOPUS:79958009321
SN - 1531-0035
VL - 12
SP - 133
EP - 148
JO - Perspectives in Vascular Surgery and Endovascular Therapy
JF - Perspectives in Vascular Surgery and Endovascular Therapy
IS - 1
ER -