A Rare Complication of EVAR: Migration of the Endograft into the Duedonum

1.32.29. A Rare Complication of EVAR: Migration of the Endograft into the DuedonumHakan Usta 1, Furkan Çelik 1, Eyüp Serhat Çalık 1, Ümit Arslan 1 and Rıfat Peksöz 21 Department of Cardiovascular Surgery, Atatürk University Faculty of Medicine,Erzurum, Türkiye2 Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum,TürkiyeBACKGROUND: EVAR is a treatment method that is increasing in popularity becauseit is easily applicable, shortens hospital stays and is a good alternative for patients whocannot tolerate surgery. Although the early results of EVAR are better compared to opensurgery, complications such as endoleak, migration, thrombosis/twisting of endograft legsand graft infection may occur.Case Presentation: A 73 year old male patient was admitted to our hospital withcomplaints of general deterioration, melena, and fever. The patient had a history ofcoronary stenting and EVAR. Patient’s laboratory findings were WBC: 17,100, Hgb: 9.5, Crp:261. CT imaging showed that stents of the EVAR graft were broken and came out of thevessel. It was seen that the EVAR graft had migrated and fistulized to the duodenum. Thepatient was operated with the simultaneous participation of cardiovascular surgery andgeneral surgery clinics. Rupture in the sigmoid colon and contamination in the abdomenMed. Sci. Forum 2025, 31, 1 141 of 249were observed. The aorta was released and a cross clamp was placed below the renal arterylevel. After the aortotomy the proximal part of the endograft and its left leg were removed.The duodenum was opened and the right leg of the graft was removed. There was no needfor Whipple prodecure. The endograft was filled with thrombus. Since there was no distalischemia before surgery, the aorta was ligated at the infrarenal level. At the same time, thesigmoid colon and rectum were excised and a colostomy was performed. The operationwas terminated and the patient was taken to intensive care. The patient developed sepsisand died at the 8th hour postoperatively.Keywords: Endograft migration; graft-enteric fistula; endograft infection<br>