A 64-year-old male was admitted with suspected aortoduodenal fistula 16 years after
transabdominal aortic reconstruction for aortoiliac occlusive disease. Computed tomography
(CT) and angiography revealed an aortoduodenal fistula and a suture-line aneurysm
at the proximal anastomosis. Due to the patient's poor general condition at the time
of diagnosis, endoluminal stent-graft implantation was chosen rather than conventional
surgery. Successful placement of the stent graft without leakage of contrast medium
and with complete exclusion of the fistula was demonstrated by CT. The patient recovered
uneventfully and was discharged 10 days after the intervention. Five months later
contrast CT indicated a recurrence of the aortoduodenal fistula. Since the patient
was now in good general condition the stent graft was removed surgically and an extra-anatomic
axillofemoral bypass was implanted. Endoluminal stent-graft Implantation is effective
as palliative therapy for aortoduodenal fistulas and is especially valuable in patients
with high risk for conventional surgery.
Endoluminal stent graft - Aorto duodenal fistula - Suture line aneurysm
