Paul A. Armstrong, DO, Martin R. Back, MD, Jeffrey S

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Presentation transcript:

Improved outcomes in the recent management of secondary aortoenteric fistula Paul A. Armstrong, DO, Martin R. Back, MD, Jeffrey S. Wilson, MD, Murray L. Shames, MD, Brad L. Johnson, MD, Dennis F. Bandyk, MD Journal of Vascular Surgery Volume 42, Issue 4, Pages 660-666 (October 2005) DOI: 10.1016/j.jvs.2005.06.020 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 (A) Contiguous gas bubble extending from duodenal lumen into perigraft space of proximal aortic graft is seen in noncontrast images of high-resolution computed tomography (CT) scan. (B) Oral contrast administration reveals direct communication between duodenum and perigraft space of an end-side proximal aortic graft reconstruction on CT scan. Adjacent native aorta remains patent. Journal of Vascular Surgery 2005 42, 660-666DOI: (10.1016/j.jvs.2005.06.020) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 Late survival after aortoenteric fistula repair was 61% at 5 years by life table methods, with infrequent deaths in patients surviving initial management (21% operative mortality). SE <10% at all time points. Journal of Vascular Surgery 2005 42, 660-666DOI: (10.1016/j.jvs.2005.06.020) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Recurrent infections of aortic stump (n = 1) or extra-anatomic bypass (n = 2) during long-term follow-up were infrequent. SE <10% for life table estimates. Journal of Vascular Surgery 2005 42, 660-666DOI: (10.1016/j.jvs.2005.06.020) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 4 After aortoenteric fistula repair, there was an 88% freedom from limb loss at 5 years. SE <10% for life-table estimates. Journal of Vascular Surgery 2005 42, 660-666DOI: (10.1016/j.jvs.2005.06.020) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 5 The rate of 5-year primary, stenosis-free patency of axillobifemoral grafts after aortoenteric fistula repair was 64%. There was an improvement of assisted patency to 79% at 5-years using long-term duplex surveillance of extra-anatomic bypass. SE <10% at all intervals. Journal of Vascular Surgery 2005 42, 660-666DOI: (10.1016/j.jvs.2005.06.020) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions