Emergent treatment of a primary aortoenteric fistula with N-butyl 2-cyanoacrylate and endovascular stent.
A novel endovascular treatment involving cyanoacrylate injection followed by endovascular stent placement is described in the setting of life-threatening acute exsanguination through a primary aortoenteric fistula. In a patient in unstable condition, N-butyl 2-cyanoacrylate was injected into the fistula tract. Rapid polymerization first provided hemostasis and allowed the patient to be resuscitated and stabilized for several hours, and then an AneuRx endovascular stent-graft was deployed to reinforce the aortic wall and permanently occlude the fistula. This approach can benefit patients whose condition would otherwise be too unstable for open surgery.
Finch
Lisa
L
University of Washington School of Medicine, Virginia Mason Medical Center, Seattle, Washington, USA.
Heathcock
R Brian
RB
Quigley
Terence
T
Jiranek
Geoffrey
G
Robinson
David
D
D000208:Acute Disease; D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic; D004630:Emergencies; D004659:Enbucrilate / Q000008:administration & dosage*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D007267:Injections; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D007421:Intestine, Small / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D015607:Stents; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000628:therapy*
D004659:Enbucrilate