Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) Technique for Delayed Post-traumatic Aortocaval Fistula: A Case Report

PURPOSE: To report a rare entity and its management that occurred at our facility: delayed traumatic aortocaval fistula with resultant cardiac, renal, and lower limbs symptoms. CASE REPORT: A 25-year-old man with history of gunshot injury and abdominal exploration 7 years ago presented with signs of congestive heart failure, high pulse pressure, right lower limb edema, and audible bruit with felt thrill with dilated veins in the anterior abdominal wall and groin. After full physical examination and imaging studies, computed tomographic angiography confirmed the diagnosis of distal aortocaval fistula, and treatment was endovascular fistula repair using covered endovascular reconstruction of aortic bifurcation (CERAB) technique. Treatment outcome was satisfactory with significant improvement of cardiac, abdominal, and peripheral manifestations 10 days after the procedure. CONCLUSION: This case demonstrates that endovascular management of distal aortocaval fistulas using CERAB technique is safe and effective.Clincal ImpactThis is the first reported case of delayed post traumatic Aorti-caval fistula has been managed using covered endovascular reconstruction of aortic bifurcation technique.