Endovascular stent-graft repair of major abdominal arteriovenous fistula: a systematic review.
OBJECTIVE
To evaluate the outcomes of endovascular stent-graft repair of major abdominal arteriovenous fistulas.


METHODS
The English literature was systematically searched using the MEDLINE electronic database up to January 2009. All reports on endovascular stent-graft repair of major abdominal arteriovenous fistula were considered. Our experience of abdominal arteriovenous fistula was involved in the data analysis. The primary outcome measures were technical success and perioperative, 30-day, and overall mortality.


RESULTS
Data for the final analysis were extracted from 21 papers reporting on 22 patients and from the medical records of a patient treated at our institution. The most common causal associations of these fistulae were the presence of an aortoiliac aneurysm and previous endovascular aneurysm repair, accounting for 56% and 13% of all associations, respectively. The technical success rate was 96% (22/23). No perioperative or 30-day mortality was noticed during a mean follow-up of 9 months. The most common procedure-related complication was type II endoleak, which was found in 22% (5/23) of the patients. This event was either self limiting or required minimal percutaneous intervention.


CONCLUSIONS
Endovascular stent-graft repair of major abdominal arteriovenous fistula is a safe and effective treatment option, with good short- and midterm results. However, no long-term data exist, and larger series are required to draw solid conclusions regarding the outcomes of this method.
Antoniou
George A
GA
Departments of Vascular Surgery, University of Thessaly Medical School, Larissa, Greece.
Koutsias
Stylianos
S
Karathanos
Christos
C
Sfyroeras
Giorgos S
GS
Vretzakis
Georgios
G
Giannoukas
Athanasios D
AD
D000005:Abdomen / Q000098:blood supply*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery; D001027:Aortography / Q000379:methods; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000601:surgery; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D012082:Renal Veins / Q000601:surgery; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery; D055815:Young Adult