Advanced Search

Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 2010 June;51(3) > The Journal of Cardiovascular Surgery 2010 June;51(3):319-27

ISSUES AND ARTICLES   MOST READ   eTOC

CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

 

The Journal of Cardiovascular Surgery 2010 June;51(3):319-27

ENDOVASCULAR MANAGEMENT OF VASCULAR EMERGENCIES 

 REVIEWS

Is EVAR the treatment of choice for aortoenteric fistula?

Lonn L., Dias N., Veith Schroeder T., Resch T.

1 Department of Vascular Surgery Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
2 Department of Cardiovascular Radiology, Rigshospitalet and University of Copenhagen Copenhagen, Denmark
3 Vascular Center Malmö-Lund, Skåne University Hospital, Malmö, Sweden

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.

language: English


FULL TEXT  REPRINTS

top of page