Title: Endovascular repair for aorto-enteric fistula: a bridge too far or a bridge to surgery?
Authors: Danneels, M I L ×
Verhagen, H J M
Teijink, J A W
Cuypers, Ph
Nevelsteen, André
Vermassen, F E G #
Issue Date: Jul-2006
Series Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery vol:32 issue:1 pages:27-33
Abstract: PURPOSE: To review our experience of endovascular treatment of aorto-enteric fistula (AEF). METHODS: Between March 1999 and March 2005, 15 patients in five university and teaching hospitals in Belgium and The Netherlands were treated for AEF by endovascular repair. Twelve (80%) were male. The mean age was 67 years. Thirteen (87%) had had previous aortic or iliac surgery, 1.7-307 months before. All patients showed clinical or biochemical signs of bleeding. Eight (53%) were in shock, five (33%) had systemic signs of infection. Eight (53%) patients were treated in an emergency setting. Ten (67%) were treated with an aortouniiliac device, three (20%) with an aortobiiliac device, one with a tube graft and one with occluders only. All patients received antibiotics postoperatively for a prolonged period of time. RESULTS: All AEF were successfully sealed, the 30-days mortality was nil. Mean hospital stay was 20 (2-81) days. One patient died 2.7 months later of postoperative complications, one died of lung cancer. Until now, there are no signs of reinfection in four (27%) patients (mean follow-up 15.7 (1-44) months). However, reinfection or recurrent AEF occurred in nine (60%) patients after 9.5 (0.61-31) months. Seven patients were reoperated successfully, two patients died after reintervention. CONCLUSION: Endovascular sealing of AEF is a promising technique, which provides time to treat shock, local and systemic infection, and co-morbidity. This creates a better situation to perform open repair in the future with possibly better outcome. Danger of reinfection remains high. Endovascular sealing of AEF should, therefore, be seen as a bridge to open surgery when possible.
ISSN: 1078-5884
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Vascular Surgery
× corresponding author
# (joint) last author

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