Endovascular Repair of a ruptured abdominal aortic and iliac artery aneurysm with an acute iliocaval fistula secondary to lymphoma |
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Authors: | Alan E Williamson Gary Annunziata Lawrence A Cone Juliann Smith |
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Institution: | (1) Department of Surgery, Eisenhower Medical Center, Rancho Mirage, CA., US;(2) Department of Medicine, Eisenhower Medical Center, Rancho Mirage, CA, US |
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Abstract: | Abdominal aortic aneurysms (AAA) are common and generally asymptomatic unless rupture occurs. A 3 to 4-cm AAA has a 1-2% risk
of rupture over 5 years. We present the case of an 85-year-old male with a history of chronic lymphocytic leukemia, a 3-cm
infrarenal AAA, and a 2-cm right common iliac artery aneurysm whose AAA ruptured and who developed an acute iliac artery–to–vena
cava fistula secondary to eroding adenopathy from an aggressive low-grade lymphoma. Initially, an open repair was attempted
but access to the aorta was not possible because of complete encasement of the infrarenal and suprarenal aorta with tumor
that was clinically invading the aortic wall. Secondary tumor invasion into the aorta is a rare complication. An endovascular
repair was accomplished with successful exclusion of both the aneurysm and the iliocaval fistula. Endovascular repair provides
a valuable alternative in the "hostile abdomen" when standard open repair may be hazardous or impossible. |
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