title: Aortoenteric fistula treated with endovascular aortic stent-graft and bilateral chimney stent-grafts to renal arteries.
abstract: We report a patient with secondary aortoenteric fistula (AEF) presenting with a rectal bleeding. The patient had multiple comorbidities, precluding major open vascular surgery. We opted to perform a two-stage procedure, where an endovascular stent-graft was first deployed to exclude the AEF from the systemic circulation. As the AEF was at the proximal anastomosis of the previous Dacron graft and close to the renal artery ostia, chimney stent-grafts were placed in both renal arteries to maintain their patency. The second stage of the procedure involved a laparotomy to repair the defect in the duodenum to prevent further contamination from bowel contents.
authors.affiliation: Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore. glenntanwl@gmail.com
authors.forename: Glenn Wei Leong
authors.initials: GW
authors.lastname: Tan
authors.forename: Daniel
authors.initials: D
authors.lastname: Wong
authors.forename: Sundeep
authors.initials: S
authors.lastname: Punamiya
authors.forename: Bien Peng
authors.initials: BP
authors.lastname: Tan
authors.forename: Charles
authors.initials: C
authors.lastname: Vu
authors.forename: Brenda
authors.initials: B
authors.lastname: Ang
authors.forename: David
authors.initials: D
authors.lastname: Foo
authors.forename: Kok Hoong
authors.initials: KH
authors.lastname: Chia
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005402:Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011474:Prosthesis Design; D012077:Renal Artery / Q000503:physiopathology / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency