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Wang et al. Vessel Plus 2018;2:3 Vessel Plus
DOI: 10.20517/2574-1209.2017.38

Case Report Open Access

Temporizing amplatzer closure of an aorto-enteric
fistula associated with a blind aortic stump via a
translumbar approach

S. Keisin Wang, Justin R. King, Ashley R. Gutwein, Raghu L. Motaganahalli, Andres Fajardo, Gary W.
Lemmon
Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

Correspondence to: Dr. S. Keisin Wang, Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine,
1801 Senate Blvd MPC# 2-3500, Indianapolis, IN 46202, USA. E-mail: wangkei@iupui.edu

How to cite this article: Wang SK, King JR, Gutwein AR, Motaganahalli RL, Fajardo A, Lemmon GW. Temporizing amplatzer closure of
an aorto-enteric fistula associated with a blind aortic stump via a translumbar approach. Vessel Plus 2018;2:3.
http://dx.doi.org/10.20517/2574-1209.2017.38
Received: 13 Dec 2017 First Decision: 17 Jan 2018 Revised: 18 Jan 2018 Accepted: 27 Jan 2018 Published: 7 Feb 2018

Science Editor: Aaron S. Dumont Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
We present a case of an aorto-enteric fistula (AEF) with chronic, persistent bleeding from a blind aortic stump
managed by endovascular means. This novel approach may have extended the life of a patient who would otherwise
have been subject to a high perioperative morbidity or persistent bleeding and death. While our patient ultimately
expired, we believe this technique can be considered for temporization in highly-selected patients.

Keywords: Aorto-enteric fistula, amplatzer vascular plug, endovascular treatment

INTRODUCTION
Aorto-enteric fistula (AEF) is a highly-morbid complication following aortic reconstruction. Although
the traditionally accepted method of treatment is open surgical repair, alternative methods need to be
considered in high operative-risk patients. We present a case of endovascular plug placement within a
blind aortic stump for treatment of an AEF 16 years after an index aorto-bifemoral bypass (ABF). While
the patient initially experienced resolution of his symptoms, this ultimately proved to be a temporizing
measure as the patient eventually died of hemorrhagic shock related to AEF progression.

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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