Endovascular management of aortoduodenal fistula arising from recurrent mycotic aneurysm in an aortic stump.

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.