Interventional treatment for traumatic AVF between ruptured
IVC and lumbar artery

Authors: Sewon Oh, Soon-Young Song

Clinical History:

Hypotension after fall down injury from 5 m height

Figure 1.

Axial and sagittal MPR CT images (a and b) show a large defect in the posterior wall of infrarenal IVC with surrounding hematoma containing pseudoaneurysm (asterisks). There is a fistulous communication (arrow) between ruptured left second lumbar artery on volume rendering image (c)

Figure 2.

Inferior venacavogram (a) shows a large pseudoaneurysm of infrarenal IVC. There is a fistulous communication between an aortic branch to IVC on abdominal aortogram (b). The fistulous communication is confirmed on left 2nd lumbar arteriography (c)

Figure 3.

Pseudoaneurysm and fistulous communication are disappeared on venacavogram (a) and abdominal aortogram (b) obtained after stent-graft insertion at infrarenal IVC and coil embolization of the left 2nd lumbar artery.

Figure 4.