Primary Aortoduodenal Fistula Supplied by Type II Endoleak

Lind, Benjamin; Jacobs, Chad E.

doi:10.1016/j.avsg.2012.02.016

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…Although millions of aneurysms have been repaired using endovascular techniques, 21 only about 30 cases of post-EVAR aortoduodenal fistula have been reported. 2,[4][5][6][7][8][9][10][11] They have resulted from either distal migration of the aortic prosthesis, secondary infection, or ongoing endoleak (type I) which served to erode then disintegrate the barrier separating the duodenum from the bloodstream. To date, all cases reported in the surgical literature have been treated with graft excision, duodenal repair and either extra-anatomic bypass or in situ aortic replacement.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Aortoenteric fistula formation following endovascular aneurysm repair (EVAR) is less likely as the aortic endoprosthesis resides inside an excluded aneurysm sac so is anatomically separated from the bowel. 2,[4][5][6][7][8][9][10][11] In general, the reported cases of aortoenteric fistula following EVAR have been treated in a similar fashion as fistula formation following open aortic repair, namely by duodenal exclusion, graft excision and either extra-anatomic bypass or in situ aortic graft replacement. [4][5][6]8,9,12 The operation is curative but also highly morbid and mortal.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Post-Evar Aortoduodenal Fistula Without Endograft Excision

Joshi

Ogbudinkpa

Stecher

et al. 2020

Vasc Endovascular Surg

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An 80 year-old gentleman presented with aortoduodenal fistula 2 months after uncomplicated endovascular aneurysm repair (EVAR). Upon laparotomy and fistula takedown, there was no active hemorrhage from the excluded aneurysm. It was theorized the fistula had originated from an occult type II endoleak which had since thrombosed. The duodenum was repaired primarily; the anterior defect in the aneurysm sac was packed and covered with omentum. The patient recovered uneventfully and remains well after 9 months. This is the first case, to our knowledge, of a post-EVAR aortoduodenal fistula successfully treated without endograft excision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of Post-Evar Aortoduodenal Fistula Without Endograft Excision

Joshi

Ogbudinkpa

Stecher

et al. 2020

Vasc Endovascular Surg

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“…Review of the literature yielded 24 previous studies, conducted between 1998 and 2018, which dealt with 32 patients with secondary AEF after EVAR 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24. Characteristics and peri-operative data obtained from case reports are shown in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Secondary Aorto-enteric Fistula and Type II Endoleak Five Years after Endovascular Abdominal Aortic Aneurysm Repair

Koda

Murakami

Yoshida

et al. 2019

EJVES Short Reports

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Introduction Secondary aorto-enteric fistula (AEF) after endovascular abdominal aortic aneurysm repair (EVAR) is a rare but potentially fatal disease. The aetiology and mechanisms are unclear. This study presents a patient who developed secondary AEF and type II endoleak five years after EVAR. Case A 73 year old man underwent successful EVAR with a bifurcated aortic stent graft for a 5.5 cm infrarenal abdominal aortic aneurysm. The aneurysm sac showed no change in size for three years, then shrank 20 mm to 3.5 cm by five years. After five years and eight months, the patient presented with fever and back pain. Enhanced CT demonstrated enlargement of the aneurysm sac, type II endoleak from the third and fourth right lumbar arteries, and air around the stent graft. An emergency operation was performed. The infected stent graft was removed by pushing up the stent graft to release the hooks from the wall of the aorta. A small fistula resembling a fish mouth measuring 1×1 cm was observed in the third part of the duodenum. The fistula was closed by direct suture, and in situ reconstruction was performed with an 18×9 mm standard polyethylene terephthalate graft. Culture of the explanted stent graft grew enterobacter. Intravenous antibiotic therapy was continued for six weeks and was stopped after confirming no recurrence of infection with computed tomography and laboratory testing. Two years later, there has been no recurrence of infection. Conclusion Long term surveillance is critical because AEF can occur even after initially successful EVAR.

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“…The site of the aneurysm and fistula was different than that of surgery (15). Thus, it was a primary form.…”

Section: Discussionmentioning

confidence: 99%

Aorto-Enteric Primary Fistula on Remote Endovascular Aneurysm Repair

Ricci¹,

Massoni²,

Giugliano³

et al. 2017

Erciyes Med J

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Aorto-Enteric Fistula (AEF) can be primary or secondary to surgery. The authors describe a case of death due to acute gastrointestinal hemorrhaging, resulting in primary AEF, in a patient who had undergone surgery in the past. The site and the pathological features of the lesion allow us to recognize the primary nature of the AEF, excluding remote surgery as a possible cause. The differential diagnosis is based on the patient's history and also on the anatomical characteristics of the lesion, such as location and extent.

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Primary Aortoduodenal Fistula Supplied by Type II Endoleak

Cited by 7 publications

References 6 publications

Treatment of Post-Evar Aortoduodenal Fistula Without Endograft Excision

Treatment of Post-Evar Aortoduodenal Fistula Without Endograft Excision

Secondary Aorto-enteric Fistula and Type II Endoleak Five Years after Endovascular Abdominal Aortic Aneurysm Repair

Aorto-Enteric Primary Fistula on Remote Endovascular Aneurysm Repair

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