Temporizing amplatzer closure of an aorto-enteric fistula associated with a blind aortic stump via a translumbar approach

Wang, S. Keisin; King, Justin R.; Gutwein, Ashley R.; Motaganahalli, Raghu L.; Fajardo, Andres; Lemmon, Gary W.

doi:10.20517/2574-1209.2017.38

Cited by 2 publications

(4 citation statements)

References 7 publications

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“…The choice of embolization device merits consideration. In the present case, but also in the cases described by others (Marone et al 2012;Wang et al 2018), an Amplatzer plug was used. This plug needs a larger access (8/9F), but has the advantage of a more rapid procedure with faster cessation of bleeding and less risk of migration.…”

Section: Discussionmentioning

confidence: 77%

“…Literature search revealed three cases in which endovascular treatment of aortic stump blow-out has been described (Marone et al 2012;Wang et al 2018;Terasaki et al 1990).…”

Section: Discussionmentioning

confidence: 99%

“…After the procedure the patient had several re-bleeds which were treated with additional coil placement. Despite this treatment, the patient expired 5 months postoperatively due to a re-bleed (Wang et al 2018).…”

Section: Discussionmentioning

confidence: 99%

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Endovascular treatment of aortic stump blow-out after extra-anatomical repair of aortoduodenal fistula: a case report and review of literature

Beijer¹,

Scholtes²,

Moerbeek³

et al. 2020

CVIR Endovasc

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Background: An aortoduodenal fistula (ADF) is an unusual, but serious complication following surgical or endovascular aortic repair. The optimal treatment for ADF consists of removal of the infected graft with in situ or extra-anatomical repair and is associated with high mortality. Part of this mortality is caused by re-bleeding or aortic stump ruptures. Classical treatment of an aortic stump rupture involves immediate re-laparotomy, removal of infected tissue, aortic stump formation and reinforcement with soft tissue flaps. However, this invasive treatment is often difficult to perform and the condition of the patient frequently requires a more rapid response. We describe a case in which an aortic stump rupture was treated endovascularly by using an Amplatzer® Vascular Plug, which successfully stopped the bleeding. Case presentation: This report describes a 67-year-old man who was presented with persistent duodenal leakage (due to secondary duodenal perforation) after resection and open in-situ repair of an infected aorto-bi-femoral prosthetic graft. An extra-anatomical reconstruction was performed with an axillo-bi-femoral bypass, followed by excision of the prosthesis, aortic stump formation, partial duodenal resection and duodenojejunal reconstruction. Twelve weeks later, sudden severe hematemesis with severe hemodynamic instability occurred. Computed tomography angiography showed extravasation of blood from the aortic stump into the duodenal loop. Endovascular treatment of the aortic stump blow-out with an Amplatzer® Vascular Plug was performed, which successfully stopped the bleeding and stabilized the patient. The duodenal fistula was treated conservatively. Three months later, the patient was discharged to a rehabilitation clinic in a good clinical condition. The patient was still alive after a follow-up of 4 years. Conclusions: Rapid treatment is requested in cases of aortic stump rupture. Re-laparotomy is practically never the most suitable solution and most of these aortic stump ruptures are fatal. Endovascular treatment could be a suitable alternative. Whether the endovascular treatment of aortic stump rupture is a definitive treatment or a bridge to surgery remains to be elucidated.

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Section: Discussionmentioning

confidence: 77%

“…Literature search revealed three cases in which endovascular treatment of aortic stump blow-out has been described (Marone et al 2012;Wang et al 2018;Terasaki et al 1990).…”

Section: Discussionmentioning

confidence: 99%

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Endovascular treatment of aortic stump blow-out after extra-anatomical repair of aortoduodenal fistula: a case report and review of literature

Beijer¹,

Scholtes²,

Moerbeek³

et al. 2020

CVIR Endovasc

View full text Add to dashboard Cite

show abstract

“…The use of these coils was due to their efficacy in occluding the opening in the distal aorta. Moreover, Wang et al 7 has shown this similar procedure done as means of palliation.…”

Section: Discussionmentioning

confidence: 93%

Endovascular Management of Aortic Stump Blowout by Parallel Grafting and Coil Embolization of Visceral Aorta

Shafique,

Quaye,

Cox

et al. 2024

Vasc Endovascular Surg

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Aortic graft and endograft infections remain a significant source of morbidity and mortality after abdominal aortic aneurysm repair. With graft excision and extra-anatomic bypass, an infrarenal aortic stump remains which can have suture line dehiscence and catastrophic stump blowout. Treatment of this is extremely challenging, especially for severely co-morbid patients who cannot undergo major surgery, or in patients with a hostile abdomen. We present a case study of a 74-year-old male found to have an aortoenteric fistula (AEF). This case broadens operative options for this type of patient population by demonstrating an endovascular technique for addressing aortic stump blowout by parallel grafting and coil embolization of the visceral aorta.

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Temporizing amplatzer closure of an aorto-enteric fistula associated with a blind aortic stump via a translumbar approach

Cited by 2 publications

References 7 publications

Endovascular treatment of aortic stump blow-out after extra-anatomical repair of aortoduodenal fistula: a case report and review of literature

Endovascular treatment of aortic stump blow-out after extra-anatomical repair of aortoduodenal fistula: a case report and review of literature

Endovascular Management of Aortic Stump Blowout by Parallel Grafting and Coil Embolization of Visceral Aorta

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