Treatment of Post-Evar Aortoduodenal Fistula Without Endograft Excision

• Published in: Vascular and endovascular surgery Vol. 55; no. 3; p. 282
• Main Authors: Joshi, Gaurang, Ogbudinkpa, Chinelo, Stecher, Johanna, Khoury, Rym El, Resnick, Daniel J, Jacobs, Chad E, White, John V, Schwartz, Lewis B
• Format: Journal Article
• Language: English
• Published: United States 01.04.2021
• Subjects: Aged, 80 and over; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - surgery; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Duodenal Diseases - diagnostic imaging; Duodenal Diseases - etiology; Duodenal Diseases - surgery; Endoleak - diagnostic imaging; Endoleak - etiology; Endoleak - surgery; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Humans; Intestinal Fistula - diagnostic imaging; Intestinal Fistula - etiology; Intestinal Fistula - surgery; Male; Reoperation; Treatment Outcome; Vascular Fistula - diagnostic imaging; Vascular Fistula - etiology; Vascular Fistula - surgery; endovascular aneurysm repair; abdominal aortic aneurysm; aortoduodenal fistula
• ISSN: 1938-9116
• DOI: 10.1177/1538574420966455

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.