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  • Title: Endovascular management of aortoduodenal fistula arising from recurrent mycotic aneurysm in an aortic stump.
    Author: Cheng M, Lee KY, Kwok PC, Fung DH, Cheung MT.
    Journal: Ann Vasc Surg; 2013 Nov; 27(8):1188.e13-7. PubMed ID: 23988552.
    Abstract:
    BACKGROUND: We present a case of successful endovascular exclusion of an aortoduodenal fistula using an endovascular graft iliac plug. This treatment modality of aortoduodenal fistula arising from a recurrent mycotic aortic aneurysm stump has not yet been described in the literature. CASE REPORT: An 80-year-old man underwent emergency repair of a ruptured infrarenal mycotic aortic aneurysm with an axillobifemoral vascular bypass. Four months after the operation, a pseudoaneurysm arising from the aortic stump invaded the third part of the duodenum, forming an aortoduodenal fistula. An endovascular graft iliac plug and a chimney stent were used to achieve endovascular exclusion of the aortoduodenal fistula. CONCLUSION: The management of aortoduodenal fistula arising from recurrent mycotic aortic aneurysm stump with an endovascular graft iliac plug is successful, especially in patients with a previous history of abdominal aortic surgeries. This procedure reduces the mortality and morbidity associated with open surgery. Further validation with a greater number of cases and longer follow-up times would be required to prove that this is a viable definitive treatment modality.
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