Outcome after endovascular stent graft repair of aortoenteric fistula: A systematic review

Antoniou, George Α.; Koutsias, Stylianos; Antoniou, Stavros A.; Georgiakakis, Andreas; Lazarides, Miltos K.; Giannoukas, Athanasios D.

doi:10.1016/j.jvs.2008.08.068

Cited by 157 publications

(135 citation statements)

References 43 publications

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“…Several reports have described the endovascular repair of AEFs. Antoniou et al 5) observed a graft infection or recurrent bleeding in 44% of mid-to long-term venous morbidity after an FV harvest is minimal. 17) The major drawback to this technique is the long operation time.…”

Section: Discussionmentioning

confidence: 99%

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Yamamoto

Igari

Toyofuku

et al. 2017

ATCS

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An arterioenteric fistula is a devastating and life-threatening condition that requires urgent treatment. Less-invasive endovascular treatment has emerged as an alternative to conventional open repair, but postoperative graft infection remains a major concern. We herein report a case of late stent graft infection after emergency endovascular repair of a secondary iliac artery-enteric fistula. The patient was a 63-year-old male who presented with a fever, who had undergone successful endovascular stent grafting for a secondary common iliac artery-enteric fistula 29 months prior. The diagnosis of a stent graft infection was confirmed via computed tomography. He underwent graft removal and in situ reconstruction with femoral vein grafts. At 6-month follow-up, the patient is in a good general condition without any symptoms.

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Section: Discussionmentioning

confidence: 99%

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Yamamoto

Igari

Toyofuku

et al. 2017

ATCS

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“…Due to the possible development of local infection and aggravation of sepsis, favorable longer-term outcomes cannot be expected. 14) On the other hand, the short-term results and longterm outcomes of radical surgery using in situ vascular reconstruction were favorable, and we consider this procedure as the standard surgical procedure for sAEFs. Endovascular stent graft repair can be chosen as an emergency evacuation measure to control bleeding for shock; but even in such cases, radical surgery should be performed as soon as possible after stabilization of the patient's general condition.…”

Section: Disclosure Statementmentioning

confidence: 95%

“…Favorable longer-term outcomes cannot be expected due to the recurrence of sepsis. 14) In our department, sAEFs have been treated by complete resection of the infected graft and intestinal fistula with in situ vascular reconstruction, with favorable results. In this study, we evaluated the results of in situ reconstruction in 10 patients with sAEFs treated between 2009 and 2012.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Surgical Treatment with In Situ Graft Reconstruction for Secondary Aorto-Enteric Fistula

Hashimoto

Gotō

Akamatsu

et al. 2016

Annals of Vascular Diseases

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Objectives:The optimal surgical management for secondary aorto-enteric fistula (sAEF) is controversial. Here, we report the long-term outcomes of a surgical treatment with in situ graft reconstruction for sAEF that was performed at our hospital. Methods: Between 2009 and 2012, 10 consecutive patients (8 males, 2 females, mean age 75.9 years) with sAEF were surgically treated with in situ graft reconstruction. Perioperative and long-term outcomes were reviewed retrospectively by medical records. Results: Clinical manifestations, including gastrointestinal bleeding, shock, sepsis, and back and abdominal pain, were observed during the treatment of the patients. In all the cases, the fistula was found between the duodenum or small intestine and the graft anastomosis, the graft itself, or pseudoaneurysm. Total graft excision and in situ graft reconstruction with omental coverage and digestive tract reconstruction was performed for all cases. There were two operative deaths because of multiple organ dysfunction syndrome and sepsis. The other patients showed no sAEF related complications, such as graft infection, and were alive during the 54-month mean follow-up period (33-76 months). Conclusion: According to our study, the long-term outcomes of surgical treatment with in situ graft reconstruction for sAEF were considered satisfactory. (This article is a translation of Jpn J Vasc Surg 2016; 25: 1-6.)

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“…Several studies continuously demonstrated that EVAR is a possible alternative procedure for infected aortic aneurysm patients with high surgical risks, with an early mortality rate less than 20%, which is comparable to that of traditional open repair. A poorer outcome was still evident in patients with aneurysm-related fistulation complication [71,72,[124][125][126][127]. Persistent infection greatly contributed to both early and late mortalities; thus, adjunctive procedures to eliminate contamination and prolonged antibiotic therapy duration after EVAR were usually advocated in the literatures [18,72,74] (see more details in Sections 7.4 and 7.5).…”

Section: Endovascular Techniquementioning

confidence: 99%

Infected Aortic Aneurysms

Lin¹,

Kan²

2017

Aortic Aneurysm

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Infected aortic aneurysms are surgical urgencies, requiring prompt management to avoid the development of catastrophic complications. Although traditional open surgery composed of radical debridement and aortic reconstruction remains the gold-standard, many favorable results of the endovascular repair strategy have been reported. In this chapter, the etiology, bacteriology, clinical manifestation, and diagnostic criteria of infected aortic aneurysms will be discussed in detail at first, followed by a comprehensive review of both traditional open surgery and endovascular repair, based on current evidences and the authors' institutional experience. Along with long-term oral antibiotic suppression and aggressive adjunctive procedures, endovascular repair for uncomplicated infected aortic aneurysms could be a definite treatment alternative to traditional open surgery in the endovascular era.

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Outcome after endovascular stent graft repair of aortoenteric fistula: A systematic review

Abstract: Endovascular stent graft repair of AEF was associated with a high incidence of infection or recurrent bleeding postoperatively. Evidence of sepsis preoperatively was indicating poor outcome.

Cited by 157 publications

References 43 publications

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Long-Term Outcomes of Surgical Treatment with In Situ Graft Reconstruction for Secondary Aorto-Enteric Fistula

Infected Aortic Aneurysms

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