Back to the list
Congress: ECR25
Poster Number: C-19209
Type: Poster: EPOS Radiologist (educational)
Authorblock: G. Pagán Vicente, I. Santiago Suárez, J. M. Ponce, A. Martínez López, C. García, J. V. Cayuela Espí, J. A. Consentino Hernández, A. Vázquez Olmos, A. Blanco Barrio; Murcia/ES
Disclosures:
Gonzalo Pagán Vicente: Nothing to disclose
Isabel Santiago Suárez: Nothing to disclose
Juan Mula Ponce: Nothing to disclose
Andrea Martínez López: Nothing to disclose
Clemente García: Nothing to disclose
José Vicente Cayuela Espí: Nothing to disclose
José Antonio Consentino Hernández: Nothing to disclose
Angel Vázquez Olmos: Nothing to disclose
Ana Blanco Barrio: Nothing to disclose
Keywords: Arteries / Aorta, Emergency, Vascular, CT-Angiography, Complications, Fistula
Learning objectives To illustrate different types of aortic fistulas (AF) and the main imaging features that canbe observed.To describe the risk factors and pathophysiology of AF.
Read more Background AF are defined as a communication between the aortic lumen and adjacent organs,such as cardiovascular structures, airway, and digestive tract.It is an uncommon pathology and its main cause is secondary to vascular procedures,both surgical and endovascular, or trauma. Primary fistulas are rarer, withatherosclerosis being the main etiology. Other less frequent ones are infections,neoplasms, collagen diseases, etc. Incidence of AF is rising due to the increase ofendovascular procedures and the prevalence of arteriosclerotic disease.AF can debut with massive bleeding, hypovolemic shock...
Read more Findings and procedure details Imaging features of AF can be divided into direct and indirect signs.Direct signs [Fig 1]:- Rarely visualised.- Visualisation of the fistula tract.- Extravasation of intravenous contrast medium into the fistulising organ or oralcontrast medium coursing into the periaortic/prosthetic space.- Aortic graft migration into the adjacent fistulizing structure.Indirect signs [Fig 1]:- Often the only available evidence.- Abnormalities of the aortic wall: aortitis, aneurysm or pseudoaneurysmformation, aortic mural thrombus, a malpositioned graft, or discontinuousatherosclerotic plaque.- Interface irregularities between the aorta and the...
Read more Conclusion Aortic fistulas are rare and potentially life-threatening pathologies that depend, in manycases, on the radiologist for correct diagnosis and management. A high index ofsuspicion is needed in patients who have a history of aneurysms, vascular repair, ortrauma and present with bleeding/shock. It is necessary to be familiar with theradiological manifestations to avoid mistakes.
Read more References 1. Gulati A, Kapoor H, Donuru A, Gala K, Parekh M. Aortic Fistulas: PathophysiologicFeatures, Imaging Findings, and Diagnostic Pitfalls. Radiographics. 2021 Sep-Oct;41(5):1335-1351. doi: 10.1148/rg.2021210004. Epub 2021 Jul 30.2. Fierro EA, Sikachi RR, Agrawal A, Verma I, Ojrzanowski M, Sahni S. Aorto-AtrialFistulas: A Contemporary Review. Cardiol Rev. 2018 May/Jun;26(3):137-144. doi:10.1097/CRD.0000000000000182.3. Picichè M, De Paulis R, Fabbri A, Chiariello L. Postoperative aortic fistulas into theairways: etiology, pathogenesis, presentation, diagnosis, and management. AnnThorac Surg. 2003 Jun;75(6):1998-2006. doi: 10.1016/s0003-4975(02)04837-3.4. Hagspiel KD, Turba UC, Bozlar...
Read more
GALLERY