Endovascular exclusion of a large spontaneous aortocaval fistula in a patient with a ruptured aortic aneurysm.

A primary aortocaval fistula (ACF) is present in less than 1% of all abdominal aortic aneurysms (AAA). The case of a 62-year-old patient with a ruptured AAA and ACF was reported. A stent-graft was implanted into the abdominal aorta. An inferior vena cava filter was inserted to prevent pulmonary embolism. The patient made a smooth recovery. The follow-up computed tomographic scan three months later did not reveal any evidence of endoleaks or that the fistula was still present. Hemodynamic changes with regard to transient acute liver impairment were discovered (renal and liver parameters were presented). Endovascular exclusion appears to be an effective option in the treatment of an aortocaval fistula in comparison to conventional open repair.