Abstract

Aortocaval fistula (ACF) is a rare complication associated with abdominal aortic aneurysm. Open repair of this entity is well described in the literature. Less well described are endovascular means for repair as well as mid and long term outcomes. We describe a case of a ruptured abdominal aortic aneurysm that presented with an aortocaval fistula and was managed with endovascular interventions on both the aorta and inferior vena cava. Following placement of an aortic stent graft, there was persistent flow through the ACF and a large Type I endoleak. Subsequent management included placement of second bifurcated stent graft in the inferior vena cava. No further endoleaks were encountered. To our knowledge, this is a unique management of a rare complication of aortic aneurysm rupture with fully endovascular exclusion of ACF.