Aortoiliac aneurysm with arteriocaval fistula treated by a bifurcated endovascular stent-graft
Related Experiment Video
Updated: Oct 29, 2026
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
C J Beveridge1, H C Pleass, J Chamberlain
1Department of Radiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Insights
This study reports a rare case of a patient with high-output cardiac failure due to an arteriocaval fistula. An endovascular stent-graft successfully treated the condition, occluding the aneurysm and fistula.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- High-output cardiac failure can be caused by arteriovenous fistulas.
- Aneurysms of the distal aorta and iliac arteries can be associated with fistulas.
- Arteriocaval fistulas are rare vascular abnormalities.
Observation:
- A 71-year-old patient presented with high-output cardiac failure.
- Ultrasound, CT, and angiography revealed a distal aortic aneurysm and an arteriocaval fistula involving the aorta and right common iliac vein.
Findings:
- An endovascular approach was chosen due to the patient's condition.
- Successful treatment involved occlusion of the right internal iliac artery followed by bifurcated stent-graft insertion.
- This procedure achieved complete aneurysm occlusion and fistula obliteration.
Implications:
- This case highlights a novel endovascular technique for managing complex aortoiliac aneurysms with arteriocaval fistulas.
- The successful outcome suggests endovascular repair is a viable option in high-risk patients.
- This approach may offer an alternative to open surgery for similar rare conditions.
Abstract:
A 71-year-old patient with high-output cardiac failure was found to have an aneurysmal distal aorta with evidence of an arteriocaval fistula on ultrasound scanning. CT demonstrated an aneurysm of the distal aorta and right common iliac artery and an intraarterial digital subtraction angiogram confirmed an arteriocaval fistula. In view of the patient's cardiac failure and general condition an endovascular stent was considered. The right internal iliac artery was occluded with Tungsten coils prior to the insertion of a bifurcated stent-graft. This resulted in total occlusion of the aneurysm and obliteration of the arteriocaval fistula. To our knowledge such a case has not been previously reported.
