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Aorto-intestinal fistula after reconstructive arterial surgery
International Surgery
|July 1, 1983
Summary
This study details surgical interventions for pseudoaneurysms in synthetic arterial grafts. The preferred treatment for aorto-intestinal fistulae involves prosthesis removal and bypass, though in-situ repair is sometimes viable.
Area of Science:
- Vascular Surgery
- Graft Complications
- Surgical Outcomes
Background:
- Synthetic arterial bifurcation grafts are used in vascular reconstructions.
- Anastomotic pseudoaneurysms are a known complication of these grafts.
- Aorto-intestinal fistulae represent a severe, life-threatening complication.
Observation:
- 184 patients with synthetic arterial bifurcation grafts were analyzed.
- 16 distal and 11 proximal anastomotic pseudoaneurysms were surgically treated.
- Four aorto-intestinal fistulae were identified among proximal pseudoaneurysms.
Findings:
- Excision of the arterial prosthesis, repair of the intestinal defect, and creation of a new extra-anatomic bypass is the recommended treatment for aorto-intestinal fistulae.
- In specific cases, excision and in-situ replacement of an aortobifemoral prosthesis can be successful.
- Patch closure of the aortic fistula is an alternative in select situations.
Implications:
- Effective management strategies for complex graft complications are crucial for patient survival.
- Treatment decisions should be individualized based on patient factors and fistula characteristics.
- Further research may refine optimal surgical techniques for these challenging scenarios.