Akwei Solomon, Altaf Nishath, Tennant William, MacSweeney Shane, Braithwaite Bruce
Queens Medical Centre, Nottingham, UK.
Vasc Endovascular Surg. 2011 Jul;45(5):442-6. doi: 10.1177/1538574411407087. Epub 2011 May 13.
To review the outcomes of patients undergoing emergency endovascular repair of aortocaval fistula (ACF) secondary to abdominal aortic aneurysm (AAA).
Four consecutive patients who underwent emergency endovascular repair of ACF associated with AAA in a tertiary institution between 2002 and 2009. Of the 4 patients, 3 had initially been misdiagnosed and managed for several days by other specialists for their symptoms prior to diagnosis of their ACF. Three patients died in the early postoperative period. The fourth patient made a satisfactory postoperative recovery but subsequently required further endovascular surgery to treat a persistent type 1 endoleak.
Our experience illustrates the importance of early diagnosis and management of ACF. Even in experienced hands, the management of spontaneous ACF associated with AAA is challenging. Endovascular surgery may still have a role in improving outcomes in these patients.
回顾腹主动脉瘤（AAA）继发主动脉腔静脉瘘（ACF）患者接受急诊血管腔内修复术的治疗结果。
2002年至2009年期间，一家三级医疗机构中4例连续接受与AAA相关的ACF急诊血管腔内修复术的患者。4例患者中，3例最初被其他专科医生误诊并针对其症状进行了数天的治疗，之后才诊断出ACF。3例患者在术后早期死亡。第4例患者术后恢复良好，但随后需要进一步进行血管腔内手术以治疗持续性Ⅰ型内漏。
我们的经验表明早期诊断和治疗ACF的重要性。即使是经验丰富的医生，治疗与AAA相关的自发性ACF也具有挑战性。血管腔内手术在改善这些患者的治疗结果方面可能仍具有作用。
