Congestive heart failure and lower extremity edema as late sequelae of unrecognized iliac arteriovenous fistula
Abstract
We report a case of a female patient with a large volume iliac arteriovenous fistula. She presented with severe congestive heart failure and unilateral leg edema. Six years before present admission she underwent surgery because of the lumbar disc protrusion. Diagnosis was delayed due to the overshadowing symptoms of co-existent aortic valve insufficiency. Contrast-enhanced multislice computed tomography with three-dimensional reconstruction confirmed the diagnosis. The fistula was closed by using an open surgical approach, and the patient completely recovered. Severe late consequences of unrecognized arteriovenous fistula are emphasized. Causes for delayed recognition of underlying pathology, as well as diagnostic and treatment options are discussed.
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References
Brewster DC, Cambria RP, Moncure AC, et al. Aortocaval and iliac arteriovenous fistulas: recognition and treatment. J Vasc Surg 1991;13(2): 253–264.
Laureys M, Tannouri F, Rommens J, Dussaussois L, Golzarian J. Percutaneous treatment of iatrogenic iliocaval fistula related to endograft placement for abdominal aortic aneurysm. J Vasc Interv Radiol. 2002;Feb;13(2 Pt 1): 211–213.
Huawei L, Bei D, Huan Z, Zilai P, Aorong T, Kemin C. Arteriovenous fistula complicating iliac artery pseudo aneurysm: diagnosis by CT angiography. JBR-BTR. 2002;Apr-May;85(2): 104–105.
Görömbey Z, Gömöry A, Békássy SM. Iatrogenic aortocaval fistula secondary to intervertebral disc surgery. A case report. Acta Chir Scand 1984;150(7): 585–587.
Takaseya T, Hiromatsu S, Akashi H, Okazaki T, Tobinaga S, Aoyagi S. A case of unilateral leg edema due to abdominal aortic aneurysm with aortocaval fistula. Ann Thorac Cardiovasc Surg. 2007;Apr;13(2):135–138.
Lim RP, Stella DL, Dowling RJ, Campbell WA, Hebbard GS. Iliocaval arteriovenous fistula presenting with multiple organ failure. Australas Radiol. 2006;50: 381–385.
Albalate M, Octavio Gomez J, Llobregat R, Fuster M. Acute renal failure due to aortocaval fistula. Nephrol Dial Transplant. 1998;13:1268–1270.
Kanbay M, Gur Gurden, Boyat F, Tasdellen A, Boyacioglu S. Spontaneous aortocaval fistula presenting with acute liver and renal failure; A case report. Turk J Gastroenterol 2004;15(3): 169–172.
Herrero A, Garcia VR, Escudero AC, Miranda CG, Espinosa NR, Lujan CV, Vea AM. Acute renal failure as a presentation of an aortocaval fistula associated with abdominal aortic aneurysm. Nephrologia 2011; 31(1): 107–127.
Delaney CP, Brady MP. Ruptured aortic aneurysm with aortocaval fistula. J R Soc Med 1998;91: 645–646.
Linton RR, White PD. Arteriovenous fistula between the right common iliac artery and the inferior vena cava: report of a case of its occurrence following an operation for a ruptured intervertebral disc with cure by operation. Arch Surg 1945;50: 6–13.
Canaud L, Hireche K, Jojeux F, D'Annoville T, Berthet JP, Marty-Ane C, Alric P. Endovascular repair of aorto-iliac artery injuries after lumbarspine surgery. Eur J Vasc Endovasc Surg 2011; 42(2): 167–171.
Wang EA, Lee MH, Wang MC, Lee HY. Iatrogenic left Iliac-Caval fistula: Imaging and endovascular treatment. AJR Am J Roentgenol. 2004; 183: 1032–1034.
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