A new approach for aortocaval fistula from ruptured abdominal aortic aneurysm. Balloon occlusion technique under echogram guidance.

Aortocaval fistula is a rare but well-recognized complication of abdominal aortic aneurysms. However, it is difficult to make preoperative diagnosis due to various clinical findings in a patient. Once the diagnosis is made surgical treatment is urgently required. Successful surgical therapy depends on control of bleeding from the fistula. We used two Forgaty balloon catheters inserted into the inferior vena cava under echogram guidance, thus restricting bleeding from the fistula. This new approach is safe and useful for intraoperative control of hemorrhage from a ruptured abdominal aortic aneurysm.