Endovascular aortic repair in a patient with secondary aortoenteric fistula and critical lower limb ischemia

The authors present successful treatment of a patient with aortoenteric fistula and chronic critical lower limb ischemia after previous aortobifemoral bypass grafting (ABF). Examination revealed intimate contact of inferior duodenal wall near proximal anastomosis and thrombosis of the right branch. The patient underwent hybrid surgery, i.e. unilateral endovascular repair and crossover replacement. Despite severe status upon admission and concomitant diseases, postoperative period was uneventful. The authors reviewed literature data regarding pathogenesis and diagnosis of secondary aortoenteric fistulas, immediate and long-term results of open and endovascular treatment, advantages and limitations of various surgical tactics and materials.