RESUMO
Estimates of the incidence of aortoenteric fistula as a sequela of surgery of the aorta range 1-2%. This complication is less common in patients who have had an aortic endograft implanted for aortoiliac aneurysm. We present three cases of aortoenteric fistula complicating endovascular treatment of abdominal aortic aneurysm (3/423 patients, 0.7% in our series).
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Doenças da Aorta/etiologia , Implante de Prótese Vascular/efeitos adversos , Úlcera Duodenal/etiologia , Fístula Intestinal/etiologia , Fístula Vascular/etiologia , Idoso , Doenças da Aorta/patologia , Doenças da Aorta/cirurgia , Úlcera Duodenal/patologia , Úlcera Duodenal/cirurgia , Evolução Fatal , Humanos , Fístula Intestinal/patologia , Fístula Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/etiologia , Reoperação , Tomografia Computadorizada por Raios X , Fístula Vascular/patologia , Fístula Vascular/cirurgiaRESUMO
Aortoiliac aneurysms are frequent entities that have very important clinical implications, especially in the younger patients. We are asked not only to save lives by preventing the rupture or repairing those that are already ruptured but also to provide an acceptable quality of life in the postoperative period. Endovascular approaches certainly give us such an expectative but are not clearly indicated in our younger patients and cannot be used routinely in those aneurysms with a yuxtarrenal origin. This is the case report of a young man with a yuxtarrenal aortoiliac inflammatory aneurysm that was treated by the interposition of an aortobifemoral bypass with the addition of endovascular devices in the hypogastric vessels to preserve the pelvic blood flow; they contribute to seal the common iliac aneurysms. This approach was useful to avoid complications during a difficult iliac dissection and was permeable within 1 year of the operation. Durability must be assessed.