Aortocaval fistula (ACF) in patients operated for ruptured aortic aneurysm (rAAA): A surgical challenge

Publikation: Konferencebidrag uden forlag/tidsskriftKonferenceabstrakt til konferenceForskningpeer review

Resumé

Aortocaval fistula (ACF) in patients operated for Ruptured Acute Aorta Aneurysm (rAAA): A surgical challenge. Introduction Aortocaval fistula is a rare complication of abdominal aortic aneurysm (AAA). It been reported to be present in less than 1% of all AAAs. ACF arise in patients with large aneurysms and is typically discovered peroperatively in patients with rAAA. Open surgical treatment is associated with high mortality and morbidity. ACF is a result of spontaneously rupture of large atherosclerotic aneurysms into the inferior vena cava in 80%, 15% arise after trauma and 5% are iatrogenic. Patients During the last 9 month, we have operated three cases with rAAA and ACF. All patients had an open, acute operation. All ACFs detected during operation. Common for all operations was that the patients had large aneurysms (>10 cm) and extensive bleeding (3-4 l) immediately when the aneurysm was clamped and opened. CT examinations done before operation but ACF not detected before the operation. All patients survived but the recovery marked by morbidity in different ways. Results Reviewing the literature, most papers include single cases and a few systemic reviews on endovascular treatment of ACF. We have reviewed ACF in a perspective of history, pathophysiology, symptomatology, and consideration of examinations, treatment now and in the future. Conclusion ACF is difficult to detect on a preoperative CT-scan. Hence, the true incidence may be underestimated. Vascular surgeon needs to know the condition and to be aware of it, since it is important to have a strategy for treatment during operation for rAAA. A screening program for AAA in the future may detect and avoid ACF in patients with large aneurysms. New endovascular treatment may decrease morbidity and mortality.
OriginalsprogEngelsk
Publikationsdato2015
StatusUdgivet - 2015
BegivenhedDansk Karkirurgisk Selskabs Årsmøde - Aarhus, Danmark
Varighed: 23. okt. 201524. okt. 2015
Konferencens nummer: 2015

Konference

KonferenceDansk Karkirurgisk Selskabs Årsmøde
Nummer2015
LandDanmark
ByAarhus
Periode23/10/201524/10/2015

Citer dette

Warning, K., Houlind, K. C., & Ravn, H. (2015). Aortocaval fistula (ACF) in patients operated for ruptured aortic aneurysm (rAAA): A surgical challenge. Abstract fra Dansk Karkirurgisk Selskabs Årsmøde, Aarhus, Danmark.
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title = "Aortocaval fistula (ACF) in patients operated for ruptured aortic aneurysm (rAAA): A surgical challenge",
abstract = "Aortocaval fistula (ACF) in patients operated for Ruptured Acute Aorta Aneurysm (rAAA): A surgical challenge. Introduction Aortocaval fistula is a rare complication of abdominal aortic aneurysm (AAA). It been reported to be present in less than 1{\%} of all AAAs. ACF arise in patients with large aneurysms and is typically discovered peroperatively in patients with rAAA. Open surgical treatment is associated with high mortality and morbidity. ACF is a result of spontaneously rupture of large atherosclerotic aneurysms into the inferior vena cava in 80{\%}, 15{\%} arise after trauma and 5{\%} are iatrogenic. Patients During the last 9 month, we have operated three cases with rAAA and ACF. All patients had an open, acute operation. All ACFs detected during operation. Common for all operations was that the patients had large aneurysms (>10 cm) and extensive bleeding (3-4 l) immediately when the aneurysm was clamped and opened. CT examinations done before operation but ACF not detected before the operation. All patients survived but the recovery marked by morbidity in different ways. Results Reviewing the literature, most papers include single cases and a few systemic reviews on endovascular treatment of ACF. We have reviewed ACF in a perspective of history, pathophysiology, symptomatology, and consideration of examinations, treatment now and in the future. Conclusion ACF is difficult to detect on a preoperative CT-scan. Hence, the true incidence may be underestimated. Vascular surgeon needs to know the condition and to be aware of it, since it is important to have a strategy for treatment during operation for rAAA. A screening program for AAA in the future may detect and avoid ACF in patients with large aneurysms. New endovascular treatment may decrease morbidity and mortality.",
author = "Karina Warning and Houlind, {Kim Christian} and Hans Ravn",
year = "2015",
language = "English",
note = "null ; Conference date: 23-10-2015 Through 24-10-2015",

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Warning, K, Houlind, KC & Ravn, H 2015, 'Aortocaval fistula (ACF) in patients operated for ruptured aortic aneurysm (rAAA): A surgical challenge', Dansk Karkirurgisk Selskabs Årsmøde, Aarhus, Danmark, 23/10/2015 - 24/10/2015.

Aortocaval fistula (ACF) in patients operated for ruptured aortic aneurysm (rAAA) : A surgical challenge. / Warning, Karina; Houlind, Kim Christian; Ravn, Hans .

2015. Abstract fra Dansk Karkirurgisk Selskabs Årsmøde, Aarhus, Danmark.

Publikation: Konferencebidrag uden forlag/tidsskriftKonferenceabstrakt til konferenceForskningpeer review

TY - ABST

T1 - Aortocaval fistula (ACF) in patients operated for ruptured aortic aneurysm (rAAA)

T2 - A surgical challenge

AU - Warning, Karina

AU - Houlind, Kim Christian

AU - Ravn, Hans

PY - 2015

Y1 - 2015

N2 - Aortocaval fistula (ACF) in patients operated for Ruptured Acute Aorta Aneurysm (rAAA): A surgical challenge. Introduction Aortocaval fistula is a rare complication of abdominal aortic aneurysm (AAA). It been reported to be present in less than 1% of all AAAs. ACF arise in patients with large aneurysms and is typically discovered peroperatively in patients with rAAA. Open surgical treatment is associated with high mortality and morbidity. ACF is a result of spontaneously rupture of large atherosclerotic aneurysms into the inferior vena cava in 80%, 15% arise after trauma and 5% are iatrogenic. Patients During the last 9 month, we have operated three cases with rAAA and ACF. All patients had an open, acute operation. All ACFs detected during operation. Common for all operations was that the patients had large aneurysms (>10 cm) and extensive bleeding (3-4 l) immediately when the aneurysm was clamped and opened. CT examinations done before operation but ACF not detected before the operation. All patients survived but the recovery marked by morbidity in different ways. Results Reviewing the literature, most papers include single cases and a few systemic reviews on endovascular treatment of ACF. We have reviewed ACF in a perspective of history, pathophysiology, symptomatology, and consideration of examinations, treatment now and in the future. Conclusion ACF is difficult to detect on a preoperative CT-scan. Hence, the true incidence may be underestimated. Vascular surgeon needs to know the condition and to be aware of it, since it is important to have a strategy for treatment during operation for rAAA. A screening program for AAA in the future may detect and avoid ACF in patients with large aneurysms. New endovascular treatment may decrease morbidity and mortality.

AB - Aortocaval fistula (ACF) in patients operated for Ruptured Acute Aorta Aneurysm (rAAA): A surgical challenge. Introduction Aortocaval fistula is a rare complication of abdominal aortic aneurysm (AAA). It been reported to be present in less than 1% of all AAAs. ACF arise in patients with large aneurysms and is typically discovered peroperatively in patients with rAAA. Open surgical treatment is associated with high mortality and morbidity. ACF is a result of spontaneously rupture of large atherosclerotic aneurysms into the inferior vena cava in 80%, 15% arise after trauma and 5% are iatrogenic. Patients During the last 9 month, we have operated three cases with rAAA and ACF. All patients had an open, acute operation. All ACFs detected during operation. Common for all operations was that the patients had large aneurysms (>10 cm) and extensive bleeding (3-4 l) immediately when the aneurysm was clamped and opened. CT examinations done before operation but ACF not detected before the operation. All patients survived but the recovery marked by morbidity in different ways. Results Reviewing the literature, most papers include single cases and a few systemic reviews on endovascular treatment of ACF. We have reviewed ACF in a perspective of history, pathophysiology, symptomatology, and consideration of examinations, treatment now and in the future. Conclusion ACF is difficult to detect on a preoperative CT-scan. Hence, the true incidence may be underestimated. Vascular surgeon needs to know the condition and to be aware of it, since it is important to have a strategy for treatment during operation for rAAA. A screening program for AAA in the future may detect and avoid ACF in patients with large aneurysms. New endovascular treatment may decrease morbidity and mortality.

M3 - Conference abstract for conference

ER -

Warning K, Houlind KC, Ravn H. Aortocaval fistula (ACF) in patients operated for ruptured aortic aneurysm (rAAA): A surgical challenge. 2015. Abstract fra Dansk Karkirurgisk Selskabs Årsmøde, Aarhus, Danmark.