Treatment of post-evar aortoduodenal fistula without endograft excision
Joshi G, Ogbudinkpa C, Stecher J, et al. Treatment of Post-Evar Aortoduodenal Fistula Without Endograft Excision [published online ahead of print, 2020 Oct 13]. Vasc Endovascular Surg. 2020;1538574420966455. doi:10.1177/1538574420966455. epub ahead of print
An 80 year-old gentleman presented with aortoduodenal fistula 2 months after uncomplicated endovascular aneurysm repair (EVAR). Upon laparotomy and fistula takedown, there was no active hemorrhage from the excluded aneurysm. It was theorized the fistula had originated from an occult type II endoleak which had since thrombosed. The duodenum was repaired primarily; the anterior defect in the aneurysm sac was packed and covered with omentum. The patient recovered uneventfully and remains well after 9 months. This is the first case, to our knowledge, of a post-EVAR aortoduodenal fistula successfully treated without endograft excision.