Endovascular repair of a bleeding secondary aortoenteric fistula with acute leg ischemia: a case report and review of the literature.
The endovascular approach seems very attractive for patients with bleeding secondary aortoenteric fistulas (SAEF) and limb ischemia, particularly when there is no associated sepsis. Aortic stent-grafting can rapidly seal the aortoenteric communication and ensure limb reperfusion. In the present case, a 53-year-old man with a bleeding SAEF and acute leg ischemia underwent aortic stent-grafting. Ten months later, CT and leukocyte scan (Tc-99m) showed no evidence of graft infection and the patient remains well 18 months postoperatively. In the typical patient with a bleeding SAEF, endoluminal treatment, if feasible anatomically, should be considered as first-choice treatment whether it represents a "bridging" step or a "definite" solution.
Department of Vascular Surgery, The Red Cross Hospital of Athens, Greece. kotsisth@otenet.gr
Thomas
T
Kotsis
Christos
C
Lioupis
Antonios
A
Tzanis
Pantelia
P
Nasiopoulou
Konstantinos
K
Goumas
Konstantinos
K
Bakoyiannis
Vasilious
V
Andrikopoulos
D000208:Acute Disease; D000792:Angiography; D001018:Aortic Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003287:Contrast Media; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004386:Duodenum / Q000098:blood supply; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007511:Ischemia; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015607:Stents
D003287:Contrast Media