Abstract
Abdominal aortic aneurysms with primary arteriovenous fistula can be clas sified into three types (ruptured, shunted, and occult) according to clinical man ifestations. Two cases, in the authors' experience, belonged to the shunted type. Abdominal continuous bruits were the most definite sign to suggest the compli cation of the fistula. B-mode imaging system, combined with directional color Doppler flowmeter, was applied to a test for precise evaluation regarding the fistula and clearly showed the location and size of the fistula, the mural thrombi, and the specific blood flow patterns through the fistula. To prevent both massive bleeding and critical pulmonary emboli through the fistula, com plete venous interruption at the bilateral common iliac veins, as well as of the inferior vena cava, was performed by means of transsaphenous insertion of three balloon catheters so that a better operative field was obtained without any complications.
Precise preoperative evaluation of the fistula, as well as prevention of pe rioperative complications, can facilitate postoperative improvement.
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