Aorto-intestinal fistula after reconstructive arterial surgery

In a group of 184 patients with synthetic, arterial bifurcation grafts, we have performed 16 operations for distal anastomotic pseudo-aneurysms and 11 for proximal anastomotic pseudoaneurysms. Four of the latter were encountered in three patients and took the form of aorto-intestinal fistulae. Excision of the arterial prosthesis, suture of the intestinal orifice and insertion of a new extra-anatomic bypass seems to be the treatment of choice. However, excision of an aortobifemoral prosthesis and replacement in situ with a new prosthesis or even suture of the aortic fistula with a patch represent acceptable treatment in certain particular situations.