Endovascular repair of four secondary aortoenteric fistulae

G. Bianchi, A. Bocca, S. Canale, R. Curci, E. Franciosi, R. Felisi, P. De Amicis, A. Argenteri

Research output: Contribution to journalArticlepeer-review

Abstract

Aortoenteric fistulae (AEF) is a rare but serious complication of aortic surgery (0.4-4%). The high mortality (28-90%) and morbility (21-60%) of surgical treatment are related to the presenting symptoms (shock and hemodynamic instability). Even if endovascular repair of aortoenteric fistulae (AEFs) is rarely described, it offers an effective short-term treatment, with immediate restoration of hemodynamic stability, and allows late surgical repair. During the last 4 years we observed 4 cases of AEFs. All patients underwent computed tomogtaphy (CT)-scan and two of them gastroscopy. Three out of four patients had an aorto-aortic graft for AAA repair, performed 6 month, 1 and 10 years before (two of them for AAA rupture) and the other one had an aorto-bifemoral graft (performed 4 years before) for aorto-iliac thrombosis. All patients underwent endovascular repair of the AEFs and broad spectrum antibiotic therapy after the procedure. All 4 procedures were immediately successful. 30-day mortality was nil, while recurrent infection rate was 50%. The reinfected patients died within 6 months. Our experience, according to the literature shows that urgent vascular operation and general surgical intervention seem to constitute an independent risk factor for the early development of an AEFs. Literature shows that superiority of endovascular procedures over traditional surgery is statistically significant for short-term mortality (20% vs. 28%) and morbidity (33% vs. 80%) and mean hospital stay (19 vs. 44 days - P

Original languageEnglish
Pages (from-to)289-294
Number of pages6
JournalItalian Journal of Vascular and Endovascular Surgery
Volume17
Issue number4
Publication statusPublished - Dec 2010

Keywords

  • Angioplasty
  • Fistula
  • Vascular surgical procedures

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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