Long-term outcome following endovascular repair of complex aortocaval fistula after nephrectomy

A 65-year-old male with a history of right nephrectomy after a gunshot wound during childhood presented with an aortocaval fistula and fistula between the right renal artery stump and inferior vena cava. Given the risk of high-output heart failure, the patient was offered intervention. The fistula was repaired with a combination of coil embolization, placement of an Amplatzer plug, and a Palmaz stent. Surveillance imaging for 9 years following his operation demonstrated continued exclusion of the fistula with no opacification of the venous system.