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Is EVAR the treatment of choice for aortoenteric fistula?

Lonn, L; Dias, Nuno LU ; Veith Schroeder, T and Resch, Tim LU (2010) In Journal of Cardiovascular Surgery 51(3). p.319-327
Abstract
Aortoenteric fistula formation is a devastating condition regardless of whether it is primary or secondary (i.e. after previous aneurysm repair) in nature. Patients present with signs and symptoms of gastrointestinal bleeding with or without signs of systemic infection and are often in a very poor clinical condition. Conventional treatment consists of extensive open surgery (extra-anatomical bypass or aortic ligation), closure of fistula tract and complete removal of any prosthetic material. This treatment is associated with high morbidity and mortality and therefore more minimally invasive options with endovascular repair have been attempted. Endovascular repair is often successful in the short-term achieving favorable immediate outcome.... (More)
Aortoenteric fistula formation is a devastating condition regardless of whether it is primary or secondary (i.e. after previous aneurysm repair) in nature. Patients present with signs and symptoms of gastrointestinal bleeding with or without signs of systemic infection and are often in a very poor clinical condition. Conventional treatment consists of extensive open surgery (extra-anatomical bypass or aortic ligation), closure of fistula tract and complete removal of any prosthetic material. This treatment is associated with high morbidity and mortality and therefore more minimally invasive options with endovascular repair have been attempted. Endovascular repair is often successful in the short-term achieving favorable immediate outcome. In the presence of systemic infection, however, EVAR alone as an ultimate solution is often followed by repeat infection and bleeding. A staged combination of EVAR treatment for acute bleeding and aggressive infection treatment with systemic and local antibiotics, surgical abscess revision and fistula tract closure might be an option in fragile patients. For patients fit for open repair, EVAR can be used as a bridging procedure to definitive repair particularly in the setting of systemic infection. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Cardiovascular Surgery
volume
51
issue
3
pages
319 - 327
publisher
Edizioni Minerva Medica
external identifiers
  • WOS:000280895300005
  • PMID:20523281
  • Scopus:77955372142
ISSN
0021-9509
language
English
LU publication?
yes
id
49653a2f-2a36-4e85-bd55-bdf931259d53 (old id 1626363)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20523281?dopt=Abstract
date added to LUP
2010-07-05 09:50:10
date last changed
2017-01-01 07:51:43
@article{49653a2f-2a36-4e85-bd55-bdf931259d53,
  abstract     = {Aortoenteric fistula formation is a devastating condition regardless of whether it is primary or secondary (i.e. after previous aneurysm repair) in nature. Patients present with signs and symptoms of gastrointestinal bleeding with or without signs of systemic infection and are often in a very poor clinical condition. Conventional treatment consists of extensive open surgery (extra-anatomical bypass or aortic ligation), closure of fistula tract and complete removal of any prosthetic material. This treatment is associated with high morbidity and mortality and therefore more minimally invasive options with endovascular repair have been attempted. Endovascular repair is often successful in the short-term achieving favorable immediate outcome. In the presence of systemic infection, however, EVAR alone as an ultimate solution is often followed by repeat infection and bleeding. A staged combination of EVAR treatment for acute bleeding and aggressive infection treatment with systemic and local antibiotics, surgical abscess revision and fistula tract closure might be an option in fragile patients. For patients fit for open repair, EVAR can be used as a bridging procedure to definitive repair particularly in the setting of systemic infection.},
  author       = {Lonn, L and Dias, Nuno and Veith Schroeder, T and Resch, Tim},
  issn         = {0021-9509},
  language     = {eng},
  number       = {3},
  pages        = {319--327},
  publisher    = {Edizioni Minerva Medica},
  series       = {Journal of Cardiovascular Surgery},
  title        = {Is EVAR the treatment of choice for aortoenteric fistula?},
  volume       = {51},
  year         = {2010},
}