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Emergent endovascular treatment of a bleeding recurrent aortoenteric fistula as a “bridge” to definitive surgical repair  Enrico Maria Marone, MD, Daniele.

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Presentation on theme: "Emergent endovascular treatment of a bleeding recurrent aortoenteric fistula as a “bridge” to definitive surgical repair  Enrico Maria Marone, MD, Daniele."— Presentation transcript:

1 Emergent endovascular treatment of a bleeding recurrent aortoenteric fistula as a “bridge” to definitive surgical repair  Enrico Maria Marone, MD, Daniele Mascia, MD, Andrea Kahlberg, MD, Yamume Tshomba, MD, Roberto Chiesa, MD  Journal of Vascular Surgery  Volume 55, Issue 4, Pages (April 2012) DOI: /j.jvs Copyright © 2012 Society for Vascular Surgery Terms and Conditions

2 Fig 1 A, Multiplanar reconstruction of preoperative computed tomography (CT) scan (top), showing abdominal aortic occlusion, with a residual patent 3-cm-long infrarenal aortic stump. Of note, left infrarenal periaortic collection (asterisk) and a patent right lumbar artery (white arrow). On axial image (bottom), an air bubble surrounding the aorta is evident (black arrow). B, After deployment of a 18-mm Amplatzer Plug II (top; black arrow) into the infrarenal aortic stump, CT scan shows thrombosis of the aorta just below the origin of the right renal artery. Also, periaortic collection is less evident (bottom). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Three-dimensional reconstruction of the postprocedural computed tomography (CT) scan, showing infrarenal aortic occlusion by the endovascular plug, in order to obtain cessation of bleeding associated with recurrent aortoenteric fistula (AEF). Of note, patent right axillo-bifemoral bypass graft. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Intraoperative photographs during open surgical conversion for recurrent aortoenteric fistula (AEF). A, The left renal vein (asterisk) and the infrarenal aorta (dashed lines) are exposed, discovering protrusion of the distal part of the endovascular plug outside the aortic wall. B, A 2-cm single duodenal transmural lesion (white arrow) is found. C, The lesion is repaired by means of simple duodenorrhaphy. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

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