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Aortic Graft Complications
Sanjeeva P. Kalva, MD, FSIR, FCIRSE
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Abnormal communication between aorta and gastrointestinal (GI) tract
              • Primary aortoenteric fistula (AEF)
                • Communication between native aorta or aortic aneurysm and GI tract
              • Secondary AEF
                • Communication between aorta and GI tract following surgical or endovascular repair with prosthetic implants

          IMAGING

          • General Features

            • Fluoroscopic Findings

              • CT Findings

                • Angiographic Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  Selected References

                                  1. Raman SP et al: Aortoenteric fistulas: spectrum of CT findings. Abdom Imaging. 38(2):367-75, 2013
                                  2. Xiromeritis K et al: Aortoenteric fistulae: present-day management. Int Surg. 96(3):266-73, 2011
                                  3. Vu QD et al: Aortoenteric fistulas: CT features and potential mimics. Radiographics. 29(1):197-209, 2009
                                  4. Baril DT et al: Evolving strategies for the treatment of aortoenteric fistulas. J Vasc Surg. 44(2):250-7, 2006
                                  5. Danneels MI et al: Endovascular repair for aorto-enteric fistula: a bridge too far or a bridge to surgery? Eur J Vasc Endovasc Surg. 32(1):27-33, 2006
                                  6. Armstrong PA et al: Improved outcomes in the recent management of secondary aortoenteric fistula. J Vasc Surg. 42(4):660-6, 2005
                                  7. Saers SJ et al: Primary aortoenteric fistula. Br J Surg. 92(2):143-52, 2005
                                  8. Yoshimoto K et al: Secondary aortoenteric fistula. J Vasc Surg. 42(4):805, 2005
                                  9. Cendan JC et al: Twenty-one cases of aortoenteric fistula: lessons for the general surgeon. Am Surg. 70(7):583-7; discussion 587, 2004
                                  10. Ghansah JN et al: Complications of major aortic and lower extremity vascular surgery. Semin Cardiothorac Vasc Anesth. 8(4):335-61, 2004
                                  11. Malinzak LE et al: Gastrointestinal complications following infrarenal endovascular aneurysm repair. Vasc Endovascular Surg. 38(2):137-42, 2004
                                  12. Perks FJ et al: Multidetector computed tomography imaging of aortoenteric fistula. J Comput Assist Tomogr. 28(3):343-7, 2004
                                  13. Bertges DJ et al: Aortoenteric fistula due to endoleak coil embolization after endovascular AAA repair. J Endovasc Ther. 10(1):130-5, 2003
                                  14. Puvaneswary M et al: Detection of aortoenteric fistula with helical CT. Australas Radiol. 47(1):67-9, 2003
                                  15. Chiesa R et al: Vascular prosthetic graft infection: epidemiology, bacteriology, pathogenesis and treatment. Acta Chir Belg. 102(4):238-47, 2002
                                  16. Burks JA Jr et al: Endovascular repair of bleeding aortoenteric fistulas: a 5-year experience. J Vasc Surg. 34(6):1055-9, 2001
                                  17. Busuttil SJ et al: Diagnosis and management of aortoenteric fistulas. Semin Vasc Surg. 14(4):302-11, 2001
                                  18. Lenzo NP et al: Aortoenteric fistula on (99m)Tc erythrocyte scintigraphy. AJR Am J Roentgenol. 177(2):477-8, 2001
                                  19. Tozzi FL et al: Primary aortoenteric fistula related to septic aortitis. Sao Paulo Med J. 119(4):150-3, 2001
                                  20. Orton DF et al: Aortic prosthetic graft infections: radiologic manifestations and implications for management. Radiographics. 20(4):977-93, 2000
                                  21. Pipinos II et al: Secondary aortoenteric fistula. Ann Vasc Surg. 14(6):688-96, 2000
                                  22. Vogt PR et al: In situ repair of aortobronchial, aortoesophageal, and aortoenteric fistulae with cryopreserved aortic homografts. J Vasc Surg. 26(1):11-7, 1997
                                  23. Kuestner LM et al: Secondary aortoenteric fistula: contemporary outcome with use of extraanatomic bypass and infected graft excision. J Vasc Surg. 21(2):184-95; discussion 195-6, 1995
                                  24. Low RN et al: Aortoenteric fistula and perigraft infection: evaluation with CT. Radiology. 175(1):157-62, 1990
                                  25. Wagner JR: Aortic graft-enteric fistula and paraprosthetic-enteric fistula: a review. Mt Sinai J Med. 56(2):150-6, 1989
                                  26. Schutte HE: Angiographic signs of aortic graft-enteric fistulae. Clin Radiol. 38(5):503-8, 1987
                                  27. O'Mara CS et al: Secondary aortoenteric fistula. A 20 year experience. Am J Surg. 142(2):203-9, 1981
                                  28. Thompson WM et al: Aortoenteric and paraprosthetic-enteric fistulas: radiologic findings. AJR Am J Roentgenol. 127(2):235-42, 1976
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Definitions

                                            • Abnormal communication between aorta and gastrointestinal (GI) tract
                                              • Primary aortoenteric fistula (AEF)
                                                • Communication between native aorta or aortic aneurysm and GI tract
                                              • Secondary AEF
                                                • Communication between aorta and GI tract following surgical or endovascular repair with prosthetic implants

                                          IMAGING

                                          • General Features

                                            • Fluoroscopic Findings

                                              • CT Findings

                                                • Angiographic Findings

                                                  • Nuclear Medicine Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  Selected References

                                                                  1. Raman SP et al: Aortoenteric fistulas: spectrum of CT findings. Abdom Imaging. 38(2):367-75, 2013
                                                                  2. Xiromeritis K et al: Aortoenteric fistulae: present-day management. Int Surg. 96(3):266-73, 2011
                                                                  3. Vu QD et al: Aortoenteric fistulas: CT features and potential mimics. Radiographics. 29(1):197-209, 2009
                                                                  4. Baril DT et al: Evolving strategies for the treatment of aortoenteric fistulas. J Vasc Surg. 44(2):250-7, 2006
                                                                  5. Danneels MI et al: Endovascular repair for aorto-enteric fistula: a bridge too far or a bridge to surgery? Eur J Vasc Endovasc Surg. 32(1):27-33, 2006
                                                                  6. Armstrong PA et al: Improved outcomes in the recent management of secondary aortoenteric fistula. J Vasc Surg. 42(4):660-6, 2005
                                                                  7. Saers SJ et al: Primary aortoenteric fistula. Br J Surg. 92(2):143-52, 2005
                                                                  8. Yoshimoto K et al: Secondary aortoenteric fistula. J Vasc Surg. 42(4):805, 2005
                                                                  9. Cendan JC et al: Twenty-one cases of aortoenteric fistula: lessons for the general surgeon. Am Surg. 70(7):583-7; discussion 587, 2004
                                                                  10. Ghansah JN et al: Complications of major aortic and lower extremity vascular surgery. Semin Cardiothorac Vasc Anesth. 8(4):335-61, 2004
                                                                  11. Malinzak LE et al: Gastrointestinal complications following infrarenal endovascular aneurysm repair. Vasc Endovascular Surg. 38(2):137-42, 2004
                                                                  12. Perks FJ et al: Multidetector computed tomography imaging of aortoenteric fistula. J Comput Assist Tomogr. 28(3):343-7, 2004
                                                                  13. Bertges DJ et al: Aortoenteric fistula due to endoleak coil embolization after endovascular AAA repair. J Endovasc Ther. 10(1):130-5, 2003
                                                                  14. Puvaneswary M et al: Detection of aortoenteric fistula with helical CT. Australas Radiol. 47(1):67-9, 2003
                                                                  15. Chiesa R et al: Vascular prosthetic graft infection: epidemiology, bacteriology, pathogenesis and treatment. Acta Chir Belg. 102(4):238-47, 2002
                                                                  16. Burks JA Jr et al: Endovascular repair of bleeding aortoenteric fistulas: a 5-year experience. J Vasc Surg. 34(6):1055-9, 2001
                                                                  17. Busuttil SJ et al: Diagnosis and management of aortoenteric fistulas. Semin Vasc Surg. 14(4):302-11, 2001
                                                                  18. Lenzo NP et al: Aortoenteric fistula on (99m)Tc erythrocyte scintigraphy. AJR Am J Roentgenol. 177(2):477-8, 2001
                                                                  19. Tozzi FL et al: Primary aortoenteric fistula related to septic aortitis. Sao Paulo Med J. 119(4):150-3, 2001
                                                                  20. Orton DF et al: Aortic prosthetic graft infections: radiologic manifestations and implications for management. Radiographics. 20(4):977-93, 2000
                                                                  21. Pipinos II et al: Secondary aortoenteric fistula. Ann Vasc Surg. 14(6):688-96, 2000
                                                                  22. Vogt PR et al: In situ repair of aortobronchial, aortoesophageal, and aortoenteric fistulae with cryopreserved aortic homografts. J Vasc Surg. 26(1):11-7, 1997
                                                                  23. Kuestner LM et al: Secondary aortoenteric fistula: contemporary outcome with use of extraanatomic bypass and infected graft excision. J Vasc Surg. 21(2):184-95; discussion 195-6, 1995
                                                                  24. Low RN et al: Aortoenteric fistula and perigraft infection: evaluation with CT. Radiology. 175(1):157-62, 1990
                                                                  25. Wagner JR: Aortic graft-enteric fistula and paraprosthetic-enteric fistula: a review. Mt Sinai J Med. 56(2):150-6, 1989
                                                                  26. Schutte HE: Angiographic signs of aortic graft-enteric fistulae. Clin Radiol. 38(5):503-8, 1987
                                                                  27. O'Mara CS et al: Secondary aortoenteric fistula. A 20 year experience. Am J Surg. 142(2):203-9, 1981
                                                                  28. Thompson WM et al: Aortoenteric and paraprosthetic-enteric fistulas: radiologic findings. AJR Am J Roentgenol. 127(2):235-42, 1976