Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.007916
Jornal Vascular Brasileiro
Case Report

Tratamento endovascular de aneurisma de aorta abdominal com fístula aorto-cava utilizando oclusor vascular concomitante a endoprótese bifurcada: relato de caso

Endovascular treatment of an abdominal aortic aneurysm with aortocaval fistula using a vascular occluder and a bifurcated endograft in a single intervention: case report

Bruno Lorenção de Almeida, Fabio Henrique Rossi, Thiago Osawa Rodrigues, Leandro Berutto Ahouagi, Sthefanie Fauve Andrade Cavalcante, Camila Bauman Beteli, Carlos Augusto Cardoso Pedra, Antônio Massamitsu Kambara

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Resumo

As fístulas aorto-cava são entidades raras e de etiologia variada, estando frequentemente associadas a significativa morbimortalidade. Acredita-se que o aumento da tensão da parede nos grandes aneurismas resulte em reação inflamatória e aderência à veia adjacente, culminando na erosão das camadas aderidas e na formação da fístula. O tratamento cirúrgico convencional tem altas taxas de mortalidade. Embolia pulmonar paradoxal e o vazamento são complicações temidas do tratamento endovascular. O uso de oclusor vascular associado a endoprótese bifurcada é boa opção no tratamento do aneurisma de aorta abdominal com fístula aorto-cava.

Palavras-chave

aneurisma aórtico; fístula aorto-cava; procedimentos endovasculares.

Abstract

Aortocaval fistulae are rare entities with a variety of etiologies and are very often associated with significant morbidity and mortality. It is believed that increased tension in the walls of large aneurysms can cause an inflammatory reaction resulting in adhesion to the adjacent vein and culminating in erosion of the adherent layers and fistula formation. Conventional surgical treatment has high mortality rates. Paradoxical pulmonary embolism and endoleaks are the most concerning complications linked with endovascular treatment. Using a vascular occluder in combination with a bifurcated endograft is a good option for the treatment of an abdominal aortic aneurysm with aortocaval fistula.

Keywords

aneurysm aortic; aortocaval fistula; endovascular procedures.

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