Hybrid treatment of a post-EVAR aortoenteric fistula

Vascular. 2014 Oct;22(5):385-9. doi: 10.1177/1708538113501661. Epub 2013 Sep 3.

Abstract

This report presents a case of secondary aortoenteric fistula after endovascular aortic repair in a fragile patient: The fistula developed due to aneurysm shrinkage and remodeling of the stent graft, resulting in a kink eroding through the aneurysm wall into the duodenum. The aortoenteric fistula was successfully treated with a hybrid procedure with endovascular aortic repair, followed by open enteroraphy and omental flap coverage of the stent graft and local antibiotic irrigation. Despite the presence of the stent graft in a previously infected field, the patient has recovered from the acute event with no septic recurrence or hemorrhage during four years of follow-up.

Keywords: Aortoenteric fistula; anerurysm; endovascular; hybrid; infection.

Publication types

  • Case Reports

MeSH terms

  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis Implantation / methods*
  • Blood Vessel Prosthesis*
  • Endoleak / diagnostic imaging
  • Endoleak / surgery*
  • Gastroscopy
  • Humans
  • Intestinal Fistula / diagnostic imaging
  • Intestinal Fistula / surgery*
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery*
  • Stents*
  • Surgical Flaps
  • Tomography, X-Ray Computed
  • Ultrasonography, Doppler, Duplex