Type II endoleak accompanied by an arteriovenous fistula between the inferior mesenteric artery and the inferior vena cava as a complication of endovascular aneurysm repair.
Artur BorkowskiJakub MłodzikGrzegorz JodłowskiMarta J MadurskaMaciej MalinowskiJan SkóraDariusz JanczakPublished in: Proceedings (Baylor University. Medical Center) (2022)
Endovascular aneurysm repair (EVAR) has become one of the most important treatments for aortic abdominal aneurysm. This method has some possible complications, including a type II endoleak (T2E). When coexisting with arteriovenous fistulas (AVF), T2E can lead to serious hemodynamic consequences and organ failure. This report describes the management of a patient with T2E coexisting with AVF following an EVAR and re-EVAR procedure. Although T2E itself may be treated with a conservative approach in some cases, in the presented patient an operative approach was necessary because of coexisting AVF. In addition, due to unusual hemodynamic conditions created by concomitant ACF and T2E, fistula closure was obtained as a result of transarterial inferior mesenteric artery embolization. Post-EVAR imaging, including ultrasound and computed tomography angiography, has proven to be essential when caring for these patients.
Keyphrases
- inferior vena cava
- end stage renal disease
- coronary artery
- newly diagnosed
- case report
- abdominal aortic aneurysm
- ejection fraction
- pulmonary embolism
- chronic kidney disease
- magnetic resonance imaging
- high resolution
- aortic dissection
- prognostic factors
- peritoneal dialysis
- pulmonary artery
- aortic aneurysm
- aortic valve
- left ventricular
- risk factors
- computed tomography
- magnetic resonance
- patient reported outcomes
- pulmonary hypertension
- pulmonary arterial hypertension
- contrast enhanced