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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aortocaval fistula (ACF) represents a rare complication of abdominal aortic aneurysm (AAA) that may lead to hyperdynamic heart failure. We briefly describe a 58-year-old man with an old myocardial infarction, who developed leg oedema and worsening exertional dyspnea due to ACF complicating an AAA. This uncommon case highlights that an appropriate investigation for AAA and ACF should be performed in high-risk patients presenting with a history of worsening leg oedema and dyspnea in the absence of an obvious precipitating factor.
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PMID:Leg oedema and exertional dyspnea due to aortocaval fistula complicating an abdominal aortic aneurysm. 1509 7

In 1989, we encountered a 68-year-old male patient with marked hyperlipoprotein(a)emia (hyperLp(a)emia), who was being treated for hypertension and arteriosclerotic obliterans (ASO) at an outpatient clinic of our hospital. He began to develop leg edema in 2002 and was referred to the Department of Internal Medicine. It was determined that he had severe hyperlipidemia (total cholesterol, 362 mg/dl), proteinuria, and hypoalbuminemia, suggesting the presence of nephrotic syndrome. On lipoprotein analysis, he was found to have very high levels of Lp(a) in the plasma (329 mg/dl). Severe atherosclerosis was also found: that is, abdominal aortic aneurysm (AAA) and coronary artery disease (CAD) were detected, in addition to ASO. After remission of the nephrotic syndrome, the plasma Lp(a) level decreased to 204 mg/dl and the total cholesterol concentration decreased to 179 mg/dl, while very high levels of Lp(a) persisted. We estimate that the markedly elevated Lp(a) plasma levels in this patient may have played some role in the progression of atherosclerosis.
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PMID:A case of marked hyperlipoprotein(a)emia associated with nephrotic syndrome and advanced atherosclerosis. 1614 4

The operative treatment of 26 aorto-caval fistulas during the last 18 years is reviewed (24 male and two female patients; average of 65.3 year). Out of 1698 cases presenting an abdominal aortic aneurysm, 406 presented with rupture, and 26 had aorto caval fistula. In 24 cases (92.3%) it concerned an atherosclerotic aneurysm. One aneurysm with aorto-caval fistula was secondary to abdominal blunt trauma (3.8%), and one due to iatrogenic injury (3.8%). The time interval between first clinical signs of aorto-caval fistula and diagnosis, ranged from 6 hours to 2 years (average 57,3 days). Clinical presentation included congestive heart failure infive patients (11.5%), extreme leg edema in 13 (50.0%), hematuria in 2 (7.0%), renal insufficiency 2 (7.0%), and scrotal edema in six patients. Diagnosis was made by means of color duplex scan in eight patients (30.7%), CT in seven patients (27%), NMR in three patients (11.5%), and angiography in seven patients (27%). Most reliable physical sign was an abdominal bruit,present in 20 patients (77%). In ten patients (38.4%) correct diagnosis was not made prior to surgery. The operative treatment consisted of transaortic suture of the vena cava (25 pts-96.0%), and aneurysm repair. Five operative deaths occurred (19,2%), and for all of them it concerned a misdiagnosis. Cause of death was myocardial infarction (one patient-3.8%), massive bleeding (one patient-3.8%), MOF (two patients-7, 0%), and colon gangrene (one patient-3.8%). Follow-up period varied from six months to 18 years (mean 4 years and two months). Long term results showed a 96% patency rate. No postoperative lower extremity venous insufficiency nor pelvic venous hypertension was observed post-operatively.
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PMID:Aorto-caval fistulas: a review of eighteen years experience. 1643 71

In a 76-year-old man bilateral leg oedema was caused by compression of the V. cava inferior by a large abdominal aortic aneurysm. The oedema resolved after an aortobiiliac prosthesis was placed.
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PMID:[Diagnostic image (300). A man with progressive bilateral leg oedema]. 1715 31

Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA), and its preoperative diagnosis is often difficult. A 71-year-old woman was admitted to our hospital due to unilateral leg edema. Abdominal computed tomography (CT) showed an abdominal aortic aneurysm (AAA), a common iliac aortic aneurysm (CIAA) and ACF was suspected. Digital subtraction angiography (DSA) was performed, enabling us to identify the region of ACF with AAA preoperatively. ACF is associated with high mortality because it is difficult to control venous bleeding from ACF. Detailed preoperative diagnosis of ACF can provide many advantages to control bleeding from ACF during an operation.
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PMID:A case of unilateral leg edema due to abdominal aortic aneurysm with aortocaval fistula. 1750 25

An 84-year-old man with chronic obstructive pulmonary disease (COPD) was referred to our institution for further treatment of severe swelling of the left lower extremity. The left iliac vein was compressed by the abdominal aortic aneurysm and a right common iliac arterial aneurysm measuring 62 mm and 45 mm in diameter and was partially thrombosed. Multiple pulmonary artery embolisms were also noted. Endovascular repair of the abdominal aortic aneurysm and the right common iliac arterial aneurysm was performed because of his respiratory dysfunction. The left leg edema gradually resolved after endovascular treatment. Six months after the treatment, computed tomography (CT) demonstrated resolution of the venous thrombus of the left lower extremity. Although open surgery is reliable treatment for iliac compression syndrome, endovascular treatment might be a feasible and an adequate therapeutic option for patients who have severe comorbidities, complications, or high frailties.
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PMID:Endovascular Repair of an Abdominal Aortic Aneurysm with Iliac Vein Compression Syndrome. 2945 68