Clevert D-A, Stickel M, Flach P, Strautz T, Horng A, Jauch K W, Reiser M
Department of Clinical Radiology, University of Munich-Grosshadern Campus, Munich, Germany.
Cardiovasc Intervent Radiol. 2007 May-Jun;30(3):480-4. doi: 10.1007/s00270-006-0143-3.
An aorto-caval fistula is a rare complication of a symptomatic or ruptured infrarenal aortic aneurysm having a frequency of 3-6%. Patients typically present with clinical signs of diffuse abdominal pain associated with increasing venous congestion and tachycardia, rapid cardiopulmonary decompensation with acute dyspnea, and an audible machinerylike bruit. Perioperative mortality is high, ranging from 20% to 60%. We report a case of an endovascular aortic repair in a patient with a symptomatic infrarenal aortic aneurysm and an aorto-caval fistula. Contrast-enhanced ultrasound seems to be a promising new diagnostic option for the diagnosis and preoperative treatment planning for patients with abdominal aortic aneurysms with rupture into the inferior vena cava. It is in addition to computed tomography angiography. It might allow a more rapid and noninvasive diagnosis, especially for patients in intensive care because of its bedside availability. Because the examination is dynamic, additional information about blood flow between the aorta and inferior cava vein can be evaluated.
主动脉-腔静脉瘘是有症状的或破裂的肾下主动脉瘤的一种罕见并发症，发生率为3%至6%。患者通常表现出弥漫性腹痛的临床体征，伴有静脉充血和心动过速加剧、急性呼吸困难导致的快速心肺功能失代偿，以及可闻及的类似机器的杂音。围手术期死亡率很高，在20%至60%之间。我们报告了一例对有症状的肾下主动脉瘤合并主动脉-腔静脉瘘患者进行血管腔内主动脉修复的病例。对比增强超声似乎是一种有前景的新诊断方法，可用于诊断腹主动脉瘤破裂入下腔静脉的患者并进行术前治疗规划。它是计算机断层血管造影之外的方法。由于其可在床边使用，它可能允许进行更快速且无创的诊断，特别是对于重症监护中的患者。因为该检查是动态的，所以可以评估关于主动脉和下腔静脉之间血流的额外信息。
