Aortoenteric fistula caused by a ruptured stent-graft: a case report

PURPOSE: To report a case of aortoenteric fistula secondary to endovascular abdominal aortic aneurysm (AAA) exclusion using the Stentor bifurcated endovascular graft. METHODS AND RESULTS: Seventeen months after a successful endovascular AAA procedure, a male patient developed upper gastrointestinal bleeding. An aortoenteric fistula was diagnosed. At operation, the endograft fabric was found to be ruptured in an area of suture disruption between the nitinol stents. Coincidentally, a pre-existing inflammatory process might have caused adhesions between the bowel and the aortic wall, predisposing to fistula formation. The patient recovered after placement of a conventional aortic graft. CONCLUSIONS: Suture disruption between the internal support stents is a recognized complication in the first-generation Stentor device. Although the case described here is probably not typical of the consequences of this sequela, it does reinforce the need for continual periodic imaging to check for signs of graft disruption in Stentor endografts. (Less)