Results from the Multicenter Study on Aortoenteric Fistulization After Stent Grafting of the Abdominal Aorta (MAEFISTO)

摘要: Objective This study investigated the frequency, clinical features, therapeutic options, and results of aortoenteric fistulas (AEFs) developing after endovascular abdominal aortic repair (EVAR). Methods Eight Italian centers with an EVAR program participated in this retrospective multicenter collected data on AEFs that developed a previous EVAR. Results A total 3932 patients underwent between 1997 2013 at participating centers. During same period, 32 presented AEF during follow-up, 21 original performed for atherosclerotic aneurysmal disease (ATS group) 11 postsurgical pseudoaneurysm (PSA group). The incidence development was 0.46% ATS group 3.9% PSA group. Anastomotic as indication to ( P  = .01) were significantly associated development. Median time diagnosis 32 months (interquartile range, 11-75 months) 14 months 10.5-21.5 months) Among five treated conservatively, two (40%) died, 7 15 months, remaining three alive median follow-up 12 months. surgically 27 patients, including stent graft explantation all cases, situ reconstruction 14 (52%), extra-anatomic bypass 13 (48%). Perioperative mortality 37% (10 27). No additional aortic-related death recorded operated-on 28 months. Conclusions Late rarely occur but risk is increased when surgery emergency. Conservative surgical treatment post-EVAR are both high mortality. However, beyond perioperative correction appears be durable midterm follow-up.