• Mohammed ElKassaby, Mahmoud Alawy, Mohamed Zaki, Niamh Hynes, Wael Tawfick, and Sherif Sultan.
• Western Vascular Institute (WVI), Department of Vascular and Endovascular Surgery, University College Hospital, Galway (UCHG), Galway, Ireland Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
• Vascular. 2014 Aug 1;22(4):306-9.

PurposePrimary aortocaval fistula (ACF) is a rare complication of ruptured abdominal aortic aneurysms (rAAA). Endovascular repair for rAAA (REVAR) provides an efficient, elegant and safe option, minimizing the risk of massive bleeding with open repair.Case ReportCase 1: An 84-year-old man presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure, pulmonary and renal impairment. An endovascular aortic aneurysm repair was undertaken and a bifurcated stent graft was deployed to treat the aneurysm and a second stent graft was deployed within the inferior vena cava to simultaneously seal the rAAA and the ACF. Case 2: A 73-year-old male patient presented with a rAAA and ACF. He exhibited manifestations of congestive heart failure and renal impairment with haematuria. REVAR was the plan for management. A bifurcated stent graft was used to treat the aneurysm and another bifurcated stent graft was placed within the inferior vena cava to seal the rAAA and the ACF.ConclusionHere in, we report the first two cases in the English literature of rAAA with ACF successfully managed with simultaneous endovascular stent-grafting of both the aorta and the inferior vena cava.© The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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