A Rare Complication of EVAR: Migration of the Endograft into the Duedonum

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Usta H., Çelik F., Çalık E., Arslan Ü., Peksöz R.

72nd Congress of the ESCVS, the European Society of CardioVascular and Endovascular Surgery, İstanbul, Türkiye, 25 - 28 Mayıs 2024, cilt.31, sa.1, ss.1-249, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 31
  • Basıldığı Şehir: İstanbul
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.1-249
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Atatürk Üniversitesi Adresli: Evet

Özet

1.32.29. A Rare Complication of EVAR: Migration of the Endograft into the Duedonum Hakan Usta 1 , Furkan Çelik 1 , Eyüp Serhat Çalık 1 , Ümit Arslan 1 and Rıfat Peksöz 2 1 Department of Cardiovascular Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye 2 Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye BACKGROUND: EVAR is a treatment method that is increasing in popularity because it is easily applicable, shortens hospital stays and is a good alternative for patients who cannot tolerate surgery. Although the early results of EVAR are better compared to open surgery, complications such as endoleak, migration, thrombosis/twisting of endograft legs and graft infection may occur. Case Presentation: A 73 year old male patient was admitted to our hospital with complaints of general deterioration, melena, and fever. The patient had a history of coronary stenting and EVAR. Patient’s laboratory findings were WBC: 17,100, Hgb: 9.5, Crp: 261. CT imaging showed that stents of the EVAR graft were broken and came out of the vessel. It was seen that the EVAR graft had migrated and fistulized to the duodenum. The patient was operated with the simultaneous participation of cardiovascular surgery and general surgery clinics. Rupture in the sigmoid colon and contamination in the abdomen Med. Sci. Forum 2025, 31, 1 141 of 249 were observed. The aorta was released and a cross clamp was placed below the renal artery level. After the aortotomy the proximal part of the endograft and its left leg were removed. The duodenum was opened and the right leg of the graft was removed. There was no need for Whipple prodecure. The endograft was filled with thrombus. Since there was no distal ischemia before surgery, the aorta was ligated at the infrarenal level. At the same time, the sigmoid colon and rectum were excised and a colostomy was performed. The operation was terminated and the patient was taken to intensive care. The patient developed sepsis and died at the 8th hour postoperatively. Keywords: Endograft migration; graft-enteric fistula; endograft infection