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In this rare case, an aortocaval fistula caused by a type I endoleak following endovascular repair of an abdominal aortic aneurysm (AAA) in a 75-year-old man was treated successfully with repeat endovascular aortic stent implantation. Postoperatively, the patient's symptoms were significantly improved, and angiography at nine months showed no endoleak in the aneurysm and no occlusion in the compressed inferior vena cava. Endovascular interventional surgery may be a safe and effective approach to treating AAA with concomitant aortocaval fistula. The use of covered stents to isolate the fistula from the venous side may not be necessary in the first stage of surgery.