Endovascular techniques in the management of acute arterioenteric fistulas.
OBJECTIVE
To report the use of endovascular techniques to emergently treat hemorrhagic complications of rare arterioenteric fistulas.


METHODS
Two patients, a 71-year-old man and a 61-year-old woman, presented with acute bleeding arising from primary arterioenteric fistulas. In the first patient, a fistula between the iliac artery and the small intestine complicated laparoscopic treatment of acute appendicitis. In the second patient, irradiation of a metastatic cervical carcinoma led to a fistula between the right iliac artery and the terminal ileum. In both patients, the hemorrhage was controlled with implantation of a Jostent Peripheral Stent-Graft. The man is alive at 3 years with a patent endograft, but the woman died 1 month after treatment from complications of tumor progression.


CONCLUSIONS
Endovascular application of covered stents provides an alternative treatment, avoiding extensive surgery. In cases of neoplastic erosion of a large vessel, endovascular stenting can offer a palliative solution.
Knape
Susanne
S
Department of Surgery, University Hospital, Vrije Universiteit Brussel, Brussels, Belgium.
Van Nieuwenhove
Yves
Y
van Tussenbroek
Frank
F
Van den Brande
Pierre
P
Delvaux
Georges
G
D000208:Acute Disease; D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D002404:Catheterization; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications*; D007412:Intestinal Fistula / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015607:Stents