In situ reconstruction with autologous graft in the treatment of secondary aortoenteric fistulas: A retrospective case series
- PMID: 31890198
- PMCID: PMC6926104
- DOI: 10.1016/j.amsu.2019.11.020
In situ reconstruction with autologous graft in the treatment of secondary aortoenteric fistulas: A retrospective case series
Abstract
Infections caused by secondary aortoenteric fistulas (SAEF) may be extremely complex and threaten patient's life. We report our surgical approach to SAEF consisting in removal of the infected graft and in situ reconstruction using an autologous venous graft. Seven consecutive patients with SAEF treated with graft removal and in situ reconstruction using an autologous venous graft from 2008 to 2017 were reviewed. Six of seven patients (86%) survived 30-day. In one case a graft thrombosis and acute lower limb ischemia occurred requiring re-operations. All patients received injective antibiotic therapy for 20 days, followed by oral therapy for 3 months. There were no major complications at long-term follow-up. Our results suggest that superficial femoral vein reconstruction of the abdominal aorta for SAEF is effective with an acceptable in-hospital mortality and low rate of major complications. We stress the importance of the deep femoral veins to create the graft because the large saphenous vein is often affected by significant intimal hyperplasia that can cause steno-occlusive complications.
Keywords: Aortic aneurism; Aortic repair; Aortoenteric fistula; Autologous graft.
© 2019 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
Conflict of interest statement
The authors declare that they have no conflict of interest.
Figures
Similar articles
-
Secondary aortoenteric fistula: contemporary outcome with use of extraanatomic bypass and infected graft excision.J Vasc Surg. 1995 Feb;21(2):184-95; discussion 195-6. doi: 10.1016/s0741-5214(95)70261-x. J Vasc Surg. 1995. PMID: 7853593
-
In situ bypass and extra-anatomic bypass procedures result in similar survival in patients with secondary aortoenteric fistulas.J Vasc Surg. 2021 Jan;73(1):210-221.e1. doi: 10.1016/j.jvs.2020.04.515. Epub 2020 May 21. J Vasc Surg. 2021. PMID: 32445832
-
Secondary Aortoenteric Fistula After Abdominal Aortic Graft Implementation in Our Own Material.Adv Clin Exp Med. 2016 Nov-Dec;25(6):1265-1271. doi: 10.17219/acem/66621. Adv Clin Exp Med. 2016. PMID: 28028982
-
Aortoenteric Fistulas Following Endovascular Aortic Aneurysm Repair: A Review.Vasc Endovascular Surg. 2025 May 9:15385744251339966. doi: 10.1177/15385744251339966. Online ahead of print. Vasc Endovascular Surg. 2025. PMID: 40340624 Review.
-
Endovascular repair of a bleeding secondary aortoenteric fistula with acute leg ischemia: a case report and review of the literature.J Vasc Interv Radiol. 2006 Mar;17(3):563-7. doi: 10.1097/01.RVI.0000202745.36419.5A. J Vasc Interv Radiol. 2006. PMID: 16567682 Review.
Cited by
-
Emergent percutaneous chimney endovascular aortic repair of a secondary aortoenteric fistula in the setting of a solitary kidney.J Vasc Surg Cases Innov Tech. 2021 Feb 19;7(2):253-257. doi: 10.1016/j.jvscit.2021.01.009. eCollection 2021 Jun. J Vasc Surg Cases Innov Tech. 2021. PMID: 33997566 Free PMC article.
References
-
- Fancellu A., Giuliani G., Feo C.F., Scanu A.M., Porcu A. Primary aortoenteric fistula. Report of a case. Ann. Ital. Chir. 2004;75(3):373–377. - PubMed
-
- Lemos D.W., Raffetto J.D., Moore T.C., Menzoian J.O. Primary aortoduodenal fistula: a case report and review of the literature. J. Vasc. Surg. 2003;37(3):686–689. - PubMed
-
- Agha R.A., Borrelli M.R., Farwana R., Koshy K., Fowler A.J., Orgill D.P., PROCESS Group The PROCESS 2018 statement: updating consensus preferred reporting of CasE series in surgery (PROCESS) guidelines. Int. J. Surg. 2018;60:279–282. - PubMed
-
- Brock R.C. Aortic homografting: a report of six successful cases. Guy’s Hosp. Rep. 1953;102(3):204–228. - PubMed
-
- Mackenzie R.J., Buell A.H., Pearson S.C. Aneurysm of aortic homo-graft with rupture into the duodenum. AMA Arch. Surg. 1958;77(6):965–969. - PubMed
Publication types
LinkOut - more resources
Full Text Sources