Secondary aortoenteric fistula after endovascular aortic interventions: a systematic literature review.
OBJECTIVE
To evaluate the collective incidence of, and experience with, aortoenteric fistula after endovascular aortoiliac therapy.


METHODS
A systematic literature research was performed to identify cases of aortoenteric fistulation after aortic stent-graft procedures or stent implantation.


RESULTS
The review revealed 16 cases of aortoenteric fistulation after aortic stent-grafting (n = 15) or stent placement (n = 1), in 14 patients with abdominal aortic aneurysm. Six had undergone endovascular aneurysm repair because of what was considered a "hostile abdomen." The symptoms did not differ from those in patients with arterioenteric fistulation after open aortic repair. A defect in the stent-graft or its function was the predominant cause of fistulation. One fistula was diagnosed at autopsy, two patients died perioperatively, and 13 survived with in situ repair or an axillobifemoral graft, all after removal of the stent-graft or stent. However, the follow-up time was short, longer than 1 year in only five of the 13 survivors.


CONCLUSIONS
Aortoenteric fistulation does occur after endovascular implantation of stents and stent-grafts. The incidence is unknown but is probably low. Follow-up time in most publications was less than 1 year, which is considered short to assess potential graft infection.
Bergqvist
David
D
Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University Hospital, Uppsala SE 751 85, Sweden. david.bergqvist@surgsci.uu.se
Björck
Martin
M
Nyman
Rickard
R
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001018:Aortic Diseases / Q000453:epidemiology*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D006801:Humans; D017543:Iliac Aneurysm / Q000601:surgery*; D015994:Incidence; D007412:Intestinal Fistula / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D015607:Stents / Q000009:adverse effects; D016157:Vascular Fistula / Q000453:epidemiology*