Aortoduodenal fistula occurring after type II endoleak treatment with coil embolization of the aortic sac.
A bifurcated stent graft device was successfully deployed to exclude an asymptomatic abdominal aortic aneurysm (AAA) with adequate proximal aortic neck morphology. At 6 months, a type II endoleak was successfully embolized through a proximal perigraft channel with metallic coils. The patient was seen with upper gastrointestinal bleeding and a pulsatile abdominal mass 11 months later. Surgical exploration revealed an aortoduodenal fistula in the vicinity of the previous embolization. We discuss the possible causes of this complication and review the literature on the subject. We conclude that aortoduodenal fistula can occur after endovascular AAA repair despite the absence of endoleak or AAA diameter increase on follow-up computed tomographic scan.
Elkouri
Stéphane
S
Division of Vascular Surgery and the Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada. elkouri@hotmail.com
Blair
Jean-Francois
JF
Thérasse
Eric
E
Oliva
Vincent L
VL
Bruneau
Luc
L
Soulez
Gilles
G
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D011183:Postoperative Complications; D011475:Prosthesis Failure; D011859:Radiography