PMID- 23173555
OWN - NLM
STAT- MEDLINE
DCOM- 20130521
LR  - 20211021
IS  - 1471-2482 (Electronic)
IS  - 1471-2482 (Linking)
VI  - 12 Suppl 1
IP  - Suppl 1
DP  - 2012
TI  - Percutaneous treatment of a aorto-caval fistula in a old high risk patient.
PG  - S32
LID - 10.1186/1471-2482-12-S1-S32 [doi]
AB  - BACKGROUND: To remark the feasibility of endovascular treatment of an aorto-caval 
      fistula in a old high risk patient with "hostile" abdomen for previous surgeries. 
      METHODS: In September 2009 a 81-years-old patient was admitted in emergency at 
      our department because of abdominal pain and massive oedema of the lower 
      extremities associated to dyspnoea (New York Heart Association (NYHA) functional 
      class III). A CT scan showed an aorto-caval fistula involving the abdominal aorta 
      below the renal arteries. This abnormal communication was likely due to the 
      previous abdominal surgeries, was complicated by occlusion of the inferior vena 
      cava at the diaphragm and was responsible for the massive oedema of the lower 
      extremities. Because of unstable conditions and hostile abdomen the patient was 
      considered unfit for conventional surgery and an endovascular approach was 
      planned. After unsuccessful attempt by positioning of an Amplatzer vascular ring 
      into the fistula, a Medtronic covered stent-grafts were implanted from the renal 
      arteries to the both common iliac arteries. The patient had an impressive 
      improvement characterized by a 18 Kg weight loss and a complete restoration of 
      the functional capacity (from NYHA class III to NYHA class I) associated to a 
      complete resolution of the lower extremities oedema as confirmed at the a 
      month-CT-scan. CONCLUSION: Endovascular surgery of aorto-caval fistula represents 
      a good option in alternative to conventional surgery mostly in old high risk 
      patient.
FAU - Rapacciuolo, Antonio
AU  - Rapacciuolo A
AD  - Department of Clinical Medicine, Cardiovascular and Immunological Sciences, 
      Federico II University of Naples, Italy.
FAU - De Angelis, Maria Carmen
AU  - De Angelis MC
FAU - di Pietro, Elisa
AU  - di Pietro E
FAU - Puglia, Roberto
AU  - Puglia R
FAU - Di Tommaso, Ettore
AU  - Di Tommaso E
FAU - Ruggiero, Danilo
AU  - Ruggiero D
FAU - Amato, Bruno
AU  - Amato B
FAU - Iannelli, Gabriele
AU  - Iannelli G
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20121115
PL  - England
TA  - BMC Surg
JT  - BMC surgery
JID - 100968567
SB  - IM
MH  - Aged, 80 and over
MH  - Aorta, Abdominal/abnormalities/surgery
MH  - Aortic Diseases/*surgery
MH  - Arteriovenous Fistula/*surgery
MH  - Blood Vessel Prosthesis Implantation/*methods
MH  - Endovascular Procedures/*methods
MH  - Humans
MH  - Male
MH  - Risk
MH  - Vena Cava, Inferior/*abnormalities/surgery
PMC - PMC3499279
EDAT- 2012/11/28 06:00
MHDA- 2013/05/23 06:00
PMCR- 2012/11/15
CRDT- 2012/11/24 06:00
PHST- 2012/11/24 06:00 [entrez]
PHST- 2012/11/28 06:00 [pubmed]
PHST- 2013/05/23 06:00 [medline]
PHST- 2012/11/15 00:00 [pmc-release]
AID - 1471-2482-12-S1-S32 [pii]
AID - 10.1186/1471-2482-12-S1-S32 [doi]
PST - ppublish
SO  - BMC Surg. 2012;12 Suppl 1(Suppl 1):S32. doi: 10.1186/1471-2482-12-S1-S32. Epub 
      2012 Nov 15.