Search: WFRF:(Leonhardt Henrik 1963)
> (2005-2009) >
Endovascular manage...
Endovascular management of acute bleeding arterioenteric fistulas.
-
- Leonhardt, Henrik, 1963 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
-
- Mellander, Stefan, 1960 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
-
- Snygg, Johan, 1963 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
-
show more...
-
- Lönn, Lars, 1956 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
-
show less...
-
(creator_code:org_t)
- 2008-01-23
- 2008
- English.
-
In: Cardiovascular and interventional radiology. - : Springer Science and Business Media LLC. - 1432-086X .- 0174-1551. ; 31:3, s. 542-9
- Related links:
-
https://gup.ub.gu.se...
-
show more...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed over the 3-year period between December 2002 and December 2005 at our institution, were retrospectively reviewed. Five patients with severe enteric bleeding underwent angiography and endovascular repair. Four presented primary arterioenteric fistulas, and one presented a secondary aortoenteric fistula. All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean follow-up time was 3 months (range, 1-6 months). All massive bleeding was controlled by occlusive balloon catheters. Four fistulas were successfully sealed with stent-grafts, resulting in a technical success rate of 80%. One patient was circulatory stabilized by endovascular management but needed immediate further open surgery. There were no procedure-related major complications. Mean hospital stay after the initial endovascular intervention was 19 days. Rebleeding occurred in four patients (80%) after a free interval of 2 weeks or longer. During the follow-up period three patients needed reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding arterioenteric fistulas in the emergent episode. However, in this group of patients with severe comorbidities, the risk of rebleeding is high and further intervention must be considered. Patients with cancer may only need treatment for the acute bleeding episode, and an endovascular approach has the advantage of low morbidity.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Acute Disease
- Aged
- Aged
- 80 and over
- Angiography
- methods
- Angioplasty
- methods
- Balloon Occlusion
- methods
- Blood Vessel Prosthesis
- Blood Vessel Prosthesis Implantation
- adverse effects
- methods
- Female
- Follow-Up Studies
- Gastrointestinal Hemorrhage
- diagnosis
- mortality
- therapy
- Hospital Mortality
- trends
- Humans
- Iliac Artery
- Intestinal Fistula
- complications
- radiography
- surgery
- Male
- Middle Aged
- Retrospective Studies
- Risk Assessment
- Severity of Illness Index
- Survival Rate
- Tomography
- X-Ray Computed
- methods
- Treatment Outcome
- Vascular Fistula
- complications
- radiography
- surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database